Joseph P. Shrum, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

11871 Issued in MS

Practice address

1245 42ND Ave
Gulfport, MS 39501-2666

Phone

(228) 864-8049

Fax

(228) 864-7655

NPI assigned

Oct 2, 2006

Last updated

Feb 5, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tulane Dermatology Affiliates

  • Dermatology Physician
  • Gulfport, MS
  • NPI 1821285438
  Medicare reassignment NPD
• Administrators of the Tulane Educational Fund

  dba Tulane University Medical Group

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  NPD (past)
• Alan T. Lewis LLC

  • MOHS-Micrographic Surgery Physician
  • Metairie, LA
  • NPI 1326319740

  Dermatology

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1417040213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 42ND AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012666",
            "telephone_number": "228-864-8049",
            "fax_number": "228-864-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 42ND AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012666",
            "telephone_number": "228-864-8049",
            "fax_number": "228-864-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRUM",
        "first_name": "JOSEPH",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MS",
            "license": "11871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC",
            "identifier": "11871",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316202",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Shepherd
• Chelsey Sherman
• Cynthia B. Shields, PT
• Donald W Shinskie, CRNA
• Sheila Lee Shipman, IDC
• Shuttleworth Chiropractic Centre PA
• Mark Read Shuttleworth, DC
• Brittany Sick, RN
• Ibis D. Sigas, M.D.
• Carolyn C Signorine, OTR/L, CHT

• Dermatology Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Dermatology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.