Medical Foundation of South Mississippi

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14403 Issued in MS

Legal business name

MEDICAL FOUNDATION OF SOUTH MISSISSIPPI

Practice address

1612 31St Ave
Gulfport, MS 39501-2750

Phone

(228) 865-1453

Fax

(228) 865-1451

NPI assigned

Aug 28, 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 1

Addresses

Other identifiers 2

Other names 1

• Weaver Family Practice Doing business as

Tax ID family

Medical Foundation of South Mississippi2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Medical Foundation of South Ms

  • Urgent Care Clinic/Center
  • Biloxi, MS
  • NPI 1609951441
  NPD tax ID

Practitioners 2

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

• Brandi Coleman, M.D.

  • Pediatrics Physician
  • Bay St Louis, MS
  • NPI 1942241922
  NPD (past)
• Catherine N Donald, M.D.

  • Pediatrics Physician
  • Gulfport, MS
  • NPI 1235171265
  NPD (past)

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1801904156",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF SOUTH MISSISSIPPI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2008-02-01",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "14403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM1261",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9014378",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weaver Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Med Link America, Inc.
• Med Management Plus
• Med-Trans Corporation
• Medi-Lab Diagnostics Center LLC
• Medi-Lift of Ms, LLC
• 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

• Family Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.