NPIMap

Individual provider Active NPI

Bobby W Tullos, M.D.

  • Pulmonary Disease Physician
  • Gulfport, MS
National Provider Identifier
1841554250
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
23030 Issued in MS
Practice address
1340 Broad Ave Ste 410
Gulfport, MS 39501-2459
Phone
(228) 575-1775
Fax
(228) 575-1770
NPI assigned
Jun 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23030 MS
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 23030 MS
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 23030 MS Primary

Addresses

Primary practice location

1340 Broad Ave Ste 410
Gulfport, MS 39501-2459

Mailing address

860 S Madison St
Tupelo, MS 38801-4905
Phone (662) 377-7150

Other identifiers 1

IdentifierTypeStateIssuer
23030OtherMSSTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141222002414 MS Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7517280647 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
University of Mississippi School of Medicine, 2012
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)

Gulfport, MS 39503
Phone (228) 867-4000

15286 Community Rd
Suite B
Gulfport, MS 39503-3509
Phone (228) 539-3356

Hospital & facility affiliations

  • Deaconess Homecare- Region I Home health agency, Laurel, MS, CCN 257085
  • Enhabit Home Health of the Gulf Coast Home health agency, Gulfport, MS, CCN 257111
  • Southern Care Inc Dba Gentiva Hospice, Biloxi, MS, CCN 251537
  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Memorial Hospital Biloxi Hospital, Biloxi, MS, CCN 250007
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
B Tullos MD LLC Multi-Specialty CurrentSince Aug 1, 2024 Accepting new patients
Memorial Hospital at Gulfport Multi-Specialty CurrentSince Jul 23, 2020 Accepting new patients
Kings Daughters Medical Center Multi-Specialty Current Accepting new patients
King'S Daughters Medical Center CurrentSince Dec 1, 2014 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Multi-Specialty CurrentSince Jan 1, 2016 Accepting new patients
Memorial Hospital at Gulfport Multi-Specialty Current Accepting new patients
Comprehensive Hospitalists of Ms, LLC Multi-Specialty Current Accepting new patients
Comprehensive Hospitalists of Ms, LLC Multi-Specialty CurrentSince Jan 1, 2016 Accepting new patients
King'S Daughters Medical Center Multi-Specialty CurrentSince Dec 1, 2014 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

147 Reynoir St
Ste 306
Biloxi, MS 39530
Phone (228) 432-1116

427 Highway 51 N
Brookhaven, MS 39601
Phone (601) 833-6011

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

15286 Community Rd
#B
Gulfport, MS 39503
Phone (228) 831-3106

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

1340 Broad Ave
Ste 300
Gulfport, MS 39501
Phone (228) 575-2700

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

Interoperability endpoints

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

Organizations & group practices 11

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 65

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

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1841554250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-377-7150",
            "fax_number": "662-377-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BROAD AVE STE 410",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012459",
            "telephone_number": "228-575-1775",
            "fax_number": "228-575-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLOS",
        "first_name": "BOBBY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "23030",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MS",
            "license": "23030",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MS",
            "license": "23030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "23030",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.