Memorial Hospital at Gulfport

Organization Active NPI Nephrology Physician · Biloxi, MS

NPI 1649585258 · NPPES record last updated Jan 3, 2011

Key facts

NPI
1649585258
Entity type
Organization (NPI type 2)
Primary specialty
Nephrology Physician 207RN0300X
Legal business name
MEMORIAL HOSPITAL AT GULFPORT
Practice address
784 Vieux Marche Mall
Biloxi, MS 39530-3822
Phone
(228) 374-7525
NPI assigned
Aug 9, 2010
Organization subpart
No

Authorized official

Name
Mr. Jeff T Steiner
Title
VP Finance
Phone
(228) 818-3106

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 765

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 765

Medicare Care Compare: Hospital

Listed as
Memorial Hospital at Gulfport CCN 250019
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Hospital certification: CCN 250019

Legal name
MEMORIAL HOSPITAL AT GULFPORT
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 19, 2009
Beds
445
Ownership / control type
Local
Organization structure
Other · Non-profit
Enrollment address
4500 13TH St
Gulfport, MS 39501-2515
Hospital subgroups
Acute care

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ajm Oustalet
Individual
Corporate Officer
Board Member
Mar 1, 2009 5%
Peggy L Noonan
Individual
Corporate Director
Director, Business Services
May 1, 2020 5%
W-2 Managing Employee
Director, Business Services
Jan 1, 2006 5%
Kent Nicaud
Individual
Corporate Director
Chief Executive Officer
Nov 1, 2008
W-2 Managing Employee
Ceo
Nov 1, 2008
Thaddeus Carter
Individual
Corporate Officer
Board Member
Aug 1, 2017 5%
Claire Tindell
Individual
Corporate Officer
Board Member
Jan 1, 2019 5%
Harrison County Board of Supervisors
Organization · Gulfport, MS
5% Or Greater Direct Ownership Interest Feb 15, 1989 50%
Carrolyn Hamilton
Individual
Corporate Director Aug 10, 2009
David H White
Individual
Corporate Director Sep 17, 1993
City of Gulfport
Organization · Gulfport, MS
5% Or Greater Direct Ownership Interest Feb 15, 1989 50%
Jennifer Dumal
Individual
W-2 Managing Employee Feb 8, 1998
Carlos Bell
Individual
Corporate Officer
Board Secretary
Nov 26, 2018 5%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080515000774 MS Part a Provider - Hospital 9537062997 This NPI is an additional NPI on the enrollment

National Provider Directory

Locations (25 of 31)

1928 Depot Way
Bay St Louis, MS 39520
Phone (228) 867-4160

2781 C T Switzer SR Dr
Ste 306
Biloxi, MS 39531
Phone (228) 248-2480

147 Reynoir St
Ste 307
Biloxi, MS 39530
Phone (228) 435-0100

1720 Medical Park Dr
#8
Biloxi, MS 39532
Phone (228) 575-2902

920 Tommy Munro Dr
Ste 100
Biloxi, MS 39532
Phone (228) 575-1234

1756 Popps Ferry Rd
Ste B
Biloxi, MS 39532
Phone (228) 575-1800

2771 Pass Rd
Ste A
Biloxi, MS 39531
Phone (228) 385-4645

970 Tommy Munro Dr
Ste A
Biloxi, MS 39532
Phone (228) 207-7102

5403 Indian Hill Blvd
Diamondhead, MS 39525
Phone (228) 255-6129

6510 Highway 90
#D
Gautier, MS 39553
Phone (228) 438-2038

1397 Broad Ave
Gulfport, MS 39501
Phone (228) 575-1945

9454 Three Rivers Rd
Ste D
Gulfport, MS 39503
Phone (228) 575-2660

1340 Broad Ave
Ste 320
Gulfport, MS 39501
Phone (228) 575-1775

1340 Broad Ave
Ste 410
Gulfport, MS 39501
Phone (228) 575-1775

20006 Highway 53
#7
Gulfport, MS 39503
Phone (228) 575-1200

1110 Broad Ave
Ste 500
Gulfport, MS 39501
Phone (228) 575-2588

22 29th St
Gulfport, MS 39507
Phone (228) 575-1333

1213 Broad Ave
Ste 3
Gulfport, MS 39501
Phone (228) 575-1865

1340 Broad Ave
Ste 270
Gulfport, MS 39501
Phone (228) 575-1234

4300B W Railroad St
Gulfport, MS 39501
Phone (228) 863-5705

8950 Lorraine Rd
Ste B
Gulfport, MS 39503
Phone (228) 575-2770

8950 Lorraine Rd
Ste A
Gulfport, MS 39503
Phone (228) 396-3238

15190 Community Rd
Ste 350
Gulfport, MS 39503
Phone (228) 539-5858

12261 Highway 49
Ste 12
Gulfport, MS 39503
Phone (228) 867-4395

1118 Broad Ave
Gulfport, MS 39501
Phone (228) 822-6474

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RN0300X Yes

Addresses

Primary practice location

784 Vieux Marche Mall
Biloxi, MS 39530-3822

Mailing address

PO Box 555
Biloxi, MS 39533-0555
Phone (228) 864-0854

Other names

  • Physicans Clinic at MHG Doing business as

Other providers in Biloxi, MS

All providers in Biloxi, MS · Nephrology Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.