NPIMap

Individual provider Active NPI

Erin Adam Dewitt, M.D.

  • Family Medicine Physician
  • Diamondhead, MS
National Provider Identifier
1508942137
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19114 Issued in MS
Practice address
4405 E Aloha Dr BLDG 1a
Diamondhead, MS 39525-3388
Phone
(228) 255-8818
Fax
(228) 255-8820
NPI assigned
Oct 27, 2006
Last updated
Apr 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MS19114 MS
Family Medicine Physician 207Q00000X 19114 MS Primary

Addresses

Primary practice location

4405 E Aloha Dr BLDG 1a
Diamondhead, MS 39525-3388

Mailing address

11163 Hidden Valley Rd
Pass Christian, MS 39571-9412
Phone (228) 586-6366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070105000426 MS Practitioner - Family Practice 0345240800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4405 E Aloha Dr
BLDG 1a
Diamondhead, MS 39525-3388
Phone (228) 255-8818

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19114MSMDFamily Medicine Physician
MS19114MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Life, PLLC Family Medicine CurrentSince Jun 1, 2015 Accepting new patients
Stone County Hospital, Inc Past Accepting new patients

Locations

4405 E Aloha Dr
Diamondhead, MS 39525
Phone (228) 222-4662

4405 E Aloha Dr
Bldg 1A
Diamondhead, MS 39525
Phone (228) 255-8815

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CEEBDA/Endpoint/CEEBDA

Organizations & group practices 2

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.

Hospital & facility affiliations 65

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1508942137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11163 HIDDEN VALLEY RD",
            "city": "PASS CHRISTIAN",
            "state": "MS",
            "postal_code": "395719412",
            "telephone_number": "228-586-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 E ALOHA DR BLDG 1A",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253388",
            "telephone_number": "228-255-8818",
            "fax_number": "228-255-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "ERIN",
        "middle_name": "ADAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "MS19114",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "19114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamondhead, MS

Sources for this page

Verify at the official NPI Registry.