Garrett Douglas
Individual provider Active NPI Acute Care Nurse Practitioner · Hattiesburg, MS
NPI 1477933745 · NPPES record last updated May 18, 2026
Key facts
- NPI
- 1477933745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 882599 (MS)
- Practice address
- 415 S 28TH Ave
Hattiesburg, MS 39401-7246 - Phone
- (601) 268-5650
- Fax
- (601) 579-5212
- NPI assigned
- Jun 2, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
10615 Jefferson Hwy
Baton Rouge, LA 70809-7230
119 Countryside Dr
Youngsivlle, LA 70592-6328
201 Methodist Blvd
Suite 100
Hattiesburg, MS 39402
37 Good Hope Rd
Columbia, MS 39429-8914
415 S 28TH Ave
Hattiesburg, MS 39401-7246
6075 Poplar Ave
Suite 401
Memphis, TN 38119-0114
62 Hwy 587
Foxworth, MS 39483
Hospital & facility affiliations
- St Luke Home Health Services
- Marion General Hospital
- Forrest General Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 58.75 of 100
- Quality
- 26.99
- Improvement activities
- 40
- Cost
- 71.92
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151009000242 | MS | Practitioner - Nurse Practitioner | 5597073635 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Michael Urgent Care of Hattiesburg LLC | Current | Accepting new patients | |
| Homedica of Mississippi, LLC | Current |
Accepting new patients | |
| Homedica of Louisiana, LLC | Current |
Accepting new patients | |
| St Michaels Urgent Care of Hattiesburg | Family | Current |
Accepting new patients |
| The Clinic at Farmers Medshoppe | Current |
Accepting new patients | |
| Medical Services of Meridian, Inc. | Current |
Accepting new patients |
Locations
62 Highway 587
Foxworth, MS 39483
Phone (601) 424-3540
1240 Broad Ave
Ste B
Gulfport, MS 39501
Phone (601) 456-5100
3700 Hardy St
Ste 10
Hattiesburg, MS 39402
Phone (601) 544-7012
2124 14th St
Meridian, MS 39301
Phone (601) 483-8811
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 882599 | MS | |
| Acute Care Nurse Practitioner | 363LA2100X | 882599 | MS | Yes |
Addresses
Primary practice location
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Mailing address
37 Good Hope Rd
Columbia, MS 39429-8914
Other practice location 1
1119 Williamsburg Rd
Columbia, MS 39429-8862
Phone (601) 456-5100
Other practice location 2
1240 Broad Ave Ste B
Gulfport, MS 39501-2416
Phone (601) 456-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007953363 | Medicaid | MS |
Other providers in Hattiesburg, MS
- DJ Shuttle & Tour Service, Inc.
- William Duncan Donald III
- Courtney Nicole Dossett
- Amy R Douglas
- Christopher John Douglas
- Laurie Evans Douglas
- Sean Philip Douglas
- Abigail Douglass
- Doves Home Care
- Lisa Cothren Dowden
All providers in Hattiesburg, MS · Acute Care Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.