NPIMap

Organization Active NPI

Heart Hypertension Cholesterol & Diabetes Care LLC

  • Cardiovascular Disease Physician
  • Gulfport, MS
National Provider Identifier
1902233778
Registry record updated Oct 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
HEART HYPERTENSION CHOLESTEROL & DIABETES CARE LLC
Practice address
15444 Dedeaux Rd Ste B
Gulfport, MS 39503-2637
Phone
(228) 832-9038
Fax
(228) 832-9990
NPI assigned
Oct 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2019

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

Authorized official

Name
Steven Smith
Title
Credentialing Manager
Phone
(502) 244-9859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

15444 Dedeaux Rd Ste B
Gulfport, MS 39503-2637

Mailing address

15444 Dedeaux Rd Ste B
Gulfport, MS 39503-2637
Phone (228) 832-9038

Other identifiers 2

IdentifierTypeStateIssuer
01050841MedicaidMS
329259OtherMSMEDICARE PTAN

Other names 1

  • PRIMARY CARE PLUS Doing business as

National Provider Directory

National Provider Directory

Locations

14055 Seaway Rd
#200
Gulfport, MS 39503
Phone (228) 832-9038

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570233600000",
    "number": "1902233778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15444 DEDEAUX RD STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032637",
            "telephone_number": "228-832-9038",
            "fax_number": "228-832-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15444 DEDEAUX RD STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032637",
            "telephone_number": "228-832-9038",
            "fax_number": "228-832-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART HYPERTENSION CHOLESTEROL & DIABETES CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2019-10-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "502-244-9859"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01050841",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "329259",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIMARY CARE PLUS",
            "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 Oct 5, 2019; 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.