NPIMap

Individual provider Active NPI

Meddol Regina McCray, NP

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1871132076
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903654 Issued in MS
Practice address
2070 30TH St
Gulfport, MS 39501-6055
Phone
(228) 369-8956
NPI assigned
Jan 6, 2020
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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 903654 MS Primary

Addresses

Primary practice location

2070 30TH St
Gulfport, MS 39501-6055

Mailing address

2070 30TH St Apt a
Gulfport, MS 39501-6056
Phone (228) 369-8956

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
I20210331001118 MS Practitioner - Nurse Practitioner 7618384074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1046 Division St
Biloxi, MS 39530-2935
Phone (228) 374-2494

23453 Central Dr
Saucier, MS 39574-7521
Phone (228) 832-7223

23457 Central Dr
A
Saucier, MS 39574-7521
Phone (228) 832-7223

715 A Division St
Biloxi, MS 39530-2209
Phone (229) 374-4991

735 Division St
Biloxi, MS 39530-2209
Phone (228) 386-1190

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
903654MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Family Health Center, Inc CurrentSince Dec 29, 2020 Accepting new patients
Coastal Family Health Center, Inc Single Specialty Current Accepting new patients
Coastal Family Health Center, Inc. CurrentSince Dec 29, 2020 Accepting new patients

Locations

1046 Division St
Biloxi, MS 39530
Phone (225) 374-2494

Interoperability endpoints

  • Direct secure messaging: meddol.mccray.p1@direct.cfhc.nextgenshare.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1871132076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 30TH ST APT A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395016056",
            "telephone_number": "228-369-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 30TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395016055",
            "telephone_number": "228-369-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRAY",
        "first_name": "MEDDOL",
        "middle_name": "REGINA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.