Coast Kidney Disease & Internal Medicine

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

15918 Issued in MS

Legal business name

COAST KIDNEY DISEASE & INTERNAL MEDICINE

Practice address

3099 Bienville Blvd
Ocean Springs, MS 39564-4308

Phone

(228) 818-9008

Fax

(228) 818-0750

NPI assigned

Sep 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Alanna N Black

Title

Office Manager

Phone

(228) 818-9008

Specialties & licenses 1

Addresses

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.

• Yvonne M Hicks, ACNP

  • Acute Care Nurse Practitioner
  • Ocean Springs, MS
  • NPI 1336128248
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497847917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3099 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644308",
            "telephone_number": "228-818-9008",
            "fax_number": "228-818-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3099 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644308",
            "telephone_number": "228-818-9008",
            "fax_number": "228-818-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST KIDNEY DISEASE & INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "ALANNA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "228-818-9008",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "15918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley B Clark, LPTA
• Lana Leigh Clayton
• CLC of Ocean Springs, LLC (Sunplex Subacute Center)
• Jennifer Adriana Clement, MS, RD, LD
• Coast Dermatopathology Group
• Coast to Coast Reliable Transportation
• Coastal Dentures & Implants
• Coastal Family Health Center, Inc (Coastal Family Health Center, Inc - St Martin High School Clinic)
• Coastal Hyperbarx LLC
• Coastal Rehab, LLC

• Nephrology Physician in Ocean Springs, MS
• Providers in Ocean Springs, MS by specialty
• Nephrology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.