Individual provider Active NPI

Taylor Ronquillo Ladner, NP

  • Nurse Practitioner
  • Ocean Springs, MS
National Provider Identifier
1790347540
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
903367 Issued in MS
Practice address
6615 Washington Ave
Ocean Springs, MS 39564-2188
Phone
(228) 334-5342
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 903367 MS Primary

Addresses

Primary practice location

6615 Washington Ave
Ocean Springs, MS 39564-2188

Mailing address

4500 13TH St
Gulfport, MS 39501-2569
Phone (228) 867-4000

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
I20191210001309 MS Practitioner - Nurse Practitioner 6204269020 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Mississippi, LLC CurrentSince Feb 26, 2021 Accepting new patients
Gulfport 49 Imaging, LLC CurrentSince May 9, 2021 Accepting new patients
Hattiesburg Urgent Care, LLC CurrentSince May 26, 2020 Accepting new patients
Maxem Health Urgent Care Diberville CurrentSince Sep 11, 2019 Accepting new patients
Ocean Springs Urgent Care CurrentSince Sep 11, 2019 Accepting new patients
Pascagoula Urgent Care CurrentSince Sep 11, 2019 Accepting new patients
Ochsner Mississippi, LLC Current Accepting new patients
Ochsner Mississippi, LLC CurrentSince Feb 26, 2021 Accepting new patients
Orange Grove Urgent Care CurrentSince Sep 11, 2019 Accepting new patients

Locations

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

10319 Diberville Blvd
Diberville, MS 39540
Phone (228) 395-2999

10556 Highway 49
Gulfport, MS 39503
Phone (228) 539-2399

6101 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 909-6240

1514 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 382-9222

2210 Denny Ave
Pascagoula, MS 39567
Phone (228) 372-6040

1839 Cooper Rd
Picayune, MS 39466
Phone (601) 651-3500

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1790347540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012569",
            "telephone_number": "228-867-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 WASHINGTON AVE",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395642188",
            "telephone_number": "228-334-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADNER",
        "first_name": "TAYLOR",
        "middle_name": "RONQUILLO",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "903367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

Verify at the official NPI Registry.