Medical Foundation of South Ms

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MEDICAL FOUNDATION OF SOUTH MS

Practice address

12100 Highway 49
Gulfport, MS 39503-3063

Phone

(228) 831-1988

Fax

(228) 831-1978

NPI assigned

Jun 24, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Randy Robinson

Title

Administrator

Phone

(228) 865-1453

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Norwood Village Medical Doing business as

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1679509293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 31ST AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012750",
            "telephone_number": "228-865-1453",
            "fax_number": "228-865-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 HIGHWAY 49",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033063",
            "telephone_number": "228-831-1988",
            "fax_number": "228-831-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF SOUTH MS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "228-865-1453",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014414",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norwood Village Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medi-Lab Diagnostics Center LLC
• Medi-Lift of Ms, LLC
• Medical Foundation of South Mississippi
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Logic Inc
• Gregory K Meekin, M.D.

• Pediatrics Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.