FMS Gulfport, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

FMS GULFPORT, LLC

Doing business as

South Mississippi Home

Practice address

3301 25TH Ave
Gulfport, MS 39501-5910

Phone

(228) 436-9819

Fax

(228) 432-1744

NPI assigned

Jul 18, 2013

Last updated

Jul 18, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Mark R Fawcett

Title

Regulatory Affairs Specialist

Phone

(781) 699-9303

Specialties & licenses 1

Addresses

Other names 1

• South Mississippi Home Doing business as

Locations

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374105600000",
    "number": "1952743049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 25TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395015910",
            "telephone_number": "228-436-9819",
            "fax_number": "228-432-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 25TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395015910",
            "telephone_number": "228-436-9819",
            "fax_number": "228-432-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMS GULFPORT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2013-07-18",
        "last_updated": "2013-07-18",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "REGULATORY AFFAIRS SPECIALIST",
        "authorized_official_telephone_number": "781-699-9303"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Mississippi Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Armand Phillip Flores, NP
• Sara Flowers
• Laura Moyer Floyd, LCSW
• Natalie Floyd
• Brandy Flynn, SLP
• Rhonda Foles, NP
• Theresa Foley, LCSW
• Roy Bennett Fontenot
• Christy Fontes, DNP
• Katanya D Ford, D.C.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Gulfport, MS
• Providers in Gulfport, MS by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.