Individual provider Active NPI

Katherine Dumal, NP-C

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1770849580
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R874864 Issued in MS
Practice address
4300 W Railroad St
Ste B
Gulfport, MS 39501-2568
Phone
(228) 863-7393
Fax
(228) 864-0546
NPI assigned
Apr 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R874864 MS Primary

Addresses

Primary practice location

4300 W Railroad St
Ste B
Gulfport, MS 39501-2568

Mailing address

PO Box 1810
Gulfport, MS 39502-1810
Phone (228) 863-7393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121015000332 MS Practitioner - Nurse Practitioner 2860642568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-3152

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R874864MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Mar 15, 2014 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Mar 15, 2014 Accepting new patients

Locations

1756 Popps Ferry Rd
Ste A
Biloxi, MS 39532
Phone (228) 865-3200

4300 W Railroad St
#B
Gulfport, MS 39501
Phone (228) 864-0854

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

Interoperability endpoints

  • Direct secure messaging: kdumal@direct.mhg.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1770849580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-863-7393",
            "fax_number": "228-864-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W RAILROAD ST",
            "address_2": "STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012568",
            "telephone_number": "228-863-7393",
            "fax_number": "228-864-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMAL",
        "first_name": "KATHERINE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R874864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.