Active NPI
Vitreoretinal Eye Center, PC
- Medical Specialty Clinic/Center
- Biloxi, MS
National Provider Identifier
1477603074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- License
- 17239
- Legal business name
- VITREORETINAL EYE CENTER, PC
- Practice address
- 962 Tommy Munro Dr Ste E
Biloxi, MS 39532-2139 - Phone
- (228) 388-7000
- Fax
- (833) 849-9899
- NPI assigned
- Jan 12, 2007
- Last updated
- Dec 5, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Avit J Gremillion, MD
- Title
- President/Owner
- Phone
- (228) 388-7000
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 023984 | LA | |
| Medical Specialty Clinic/Center | 261QM2500X | 17239 | MS | Primary |
| Retina Specialist (Ophthalmology) Physician | 207WX0107X | NU |
Addresses
Primary practice location
962 Tommy Munro Dr Ste E
Biloxi, MS 39532-2139
Mailing address
962 Tommy Munro Dr Ste E
Biloxi, MS 39532-2139
Phone (228) 388-7000
Other practice location 1
67186 Industry Ln Ste A
Covington, LA 70433-8708
Phone (985) 867-9100
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05109745 | Medicaid | MS | |
| 08623204 | Medicaid | MS | |
| 438354140B | Other | MS | BLUE CROSS BLUE SHIELD MS |
| 7812033 | Other | MS | AETNA |
| 438354140A | Other | LA | LA BCBS |
| DE8313 | Other | MS | MEDICARE RAILROAD |
| 1486787 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS, LA
Enrollment records 2
National Provider Directory
National Provider DirectoryLocations
967 Cedar Lake Rd
#A
Biloxi, MS 39532
Phone (228) 205-6830
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1701734400000",
"number": "1477603074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "962 TOMMY MUNRO DR STE E",
"city": "BILOXI",
"state": "MS",
"postal_code": "395322139",
"telephone_number": "228-388-7000",
"fax_number": "833-849-9899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "962 TOMMY MUNRO DR STE E",
"city": "BILOXI",
"state": "MS",
"postal_code": "395322139",
"telephone_number": "228-388-7000",
"fax_number": "833-849-9899"
}
],
"practiceLocations": [
{
"address_1": "67186 Industry Ln Ste A",
"address_purpose": "LOCATION",
"city": "Covington",
"state": "LA",
"postal_code": "704338708",
"country_code": "US",
"telephone_number": "985-867-9100",
"fax_number": "833-849-9899",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "VITREORETINAL EYE CENTER, PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-12",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A",
"authorized_official_last_name": "GREMILLION",
"authorized_official_first_name": "AVIT",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "228-388-7000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "LA",
"license": "023984",
"primary": false
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "MS",
"license": "17239",
"primary": true
},
{
"code": "207WX0107X",
"taxonomy_group": "",
"desc": "Ophthalmology, Retina Specialist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05109745",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08623204",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MS",
"identifier": "438354140B",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7812033",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA BCBS",
"identifier": "438354140A",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "DE8313",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1486787",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Biloxi, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.