NPIMap

Organization Active NPI

Gulfport Wellness Center Inc

Doing business as Health Fit M.D. Wellness & Weight Loss

  • Clinic/Center
  • Gulfport, MS
National Provider Identifier
1881134740
Registry record updated Feb 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
18668 Issued in MS
Legal business name
GULFPORT WELLNESS CENTER INC
Doing business as
Health Fit M.D. Wellness & Weight Loss
Practice address
12261 Highway 49
Suite 6
Gulfport, MS 39503-2975
Phone
(228) 206-0542
Fax
(228) 206-0550
NPI assigned
Feb 26, 2017
Last updated
Feb 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2017

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

Authorized official

Name
Mr. Matthew Joseph Shannon
Title
President/Cfo
Phone
(501) 339-6067

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 18668 MS Primary

Addresses

Primary practice location

12261 Highway 49
Suite 6
Gulfport, MS 39503-2975

Mailing address

12261 Highway 49
Suite 6
Gulfport, MS 39503-2975
Phone (228) 206-0542

Other names 1

  • Health Fit M.D. Wellness & Weight Loss Doing business as

National Provider Directory

National Provider Directory

Locations

12261 Highway 49
Ste 6
Gulfport, MS 39503
Phone (228) 206-0542

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1488067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488067200000",
    "number": "1881134740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12261 HIGHWAY 49",
            "address_2": "SUITE 6",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032975",
            "telephone_number": "228-206-0542",
            "fax_number": "228-206-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12261 HIGHWAY 49",
            "address_2": "SUITE 6",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032975",
            "telephone_number": "228-206-0542",
            "fax_number": "228-206-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULFPORT WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-26",
        "last_updated": "2017-02-26",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT/CFO",
        "authorized_official_telephone_number": "501-339-6067",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "18668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Fit M.D. Wellness & Weight Loss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 26, 2017; 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.