NPIMap

Organization Active NPI

North Plantation

Doing business as Mindful Matters

  • Child & Adolescent Psychiatry Physician
  • Gulfport, MS
National Provider Identifier
1639620560
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
21689 Issued in MS
Legal business name
NORTH PLANTATION
Doing business as
Mindful Matters
Practice address
1613 23Rd Avenue
Gulfport, MS 39501
Phone
(228) 284-4651
Fax
(228) 284-4636
NPI assigned
Oct 15, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Brian Andrew Hammock, M.D.
Title
Owner
Phone
(228) 284-4651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X 21689 MS Primary

Addresses

Primary practice location

1613 23Rd Avenue
Gulfport, MS 39501

Mailing address

1613 23Rd Avenue
Gulfport, MS 39501
Phone (228) 224-4651

Other names 1

  • Mindful Matters Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1476489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1639620560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 23RD AVENUE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-224-4651",
            "fax_number": "228-284-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 23RD AVENUE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-284-4651",
            "fax_number": "228-284-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PLANTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HAMMOCK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-284-4651",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MS",
            "license": "21689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Matters",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.