Medical Foundation of South Ms

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MEDICAL FOUNDATION OF SOUTH MS

Practice address

1340 Broad Ave
Suite 310
Gulfport, MS 39501-2418

Phone

(228) 864-6629

Fax

(228) 864-6669

NPI assigned

Jun 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Randy Robinson

Title

Administrator

Phone

(228) 865-1453

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• South Coast Internists Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1922034073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 31ST AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012750",
            "telephone_number": "228-865-1453",
            "fax_number": "228-865-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BROAD AVE",
            "address_2": "SUITE 310",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012418",
            "telephone_number": "228-864-6629",
            "fax_number": "228-864-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL FOUNDATION OF SOUTH MS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "228-865-1453",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05900013",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Coast Internists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Foundation of South Ms
• Medical Logic Inc
• Gregory K Meekin, M.D.
• Shawn Xun Mei, MD
• Shelly Meiners, CRNA
• Philip Batson Mellen, MD

• Internal Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.