NPIMap

Organization Active NPI

Memorial Hospital at Gulfport

  • Internal Medicine Physician
  • Gulfport, MS
National Provider Identifier
1851726202
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEMORIAL HOSPITAL AT GULFPORT
Practice address
4500 13TH St
Cardio-Vascular Lab
Gulfport, MS 39501-2515
Phone
(228) 575-2902
Fax
(228) 867-5245
NPI assigned
Sep 4, 2013
Last updated
Jun 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Authorized official

Name
Jeffrey T Steiner
Title
VP of Finance
Phone
(228) 867-4000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Interventional Cardiology Physician 207RI0011X
Neurology Physician 2084N0400X
Vascular & Interventional Radiology Physician 2085R0204X

Addresses

Primary practice location

4500 13TH St
Cardio-Vascular Lab
Gulfport, MS 39501-2515

Mailing address

4500 13TH St
Cardio-Vascular Lab
Gulfport, MS 39501-2515
Phone (228) 575-2902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090515000396 MS Part B Supplier - Clinic/Group Practice 2466524012 Receives reassigned benefits from 753 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

4500 W Railroad St
Gulfport, MS 39501
Phone (228) 863-8836

4577 13th St
Gulfport, MS 39501
Phone (228) 864-2752

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1851726202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "address_2": "CARDIO-VASCULAR LAB",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-575-2902",
            "fax_number": "228-867-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "address_2": "CARDIO-VASCULAR LAB",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-575-2902",
            "fax_number": "228-867-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL AT GULFPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-04",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "STEINER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "228-867-4000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.