Individual provider Active NPI

Christopher M Gilmore, FNP-BC

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1972320604
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906968 Issued in MS
Practice address
15020 Camp LN
Gulfport, MS 39503-6245
Phone
(228) 223-7250
NPI assigned
Sep 24, 2024
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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 906968 MS Primary

Addresses

Primary practice location

15020 Camp LN
Gulfport, MS 39503-6245

Mailing address

15020 Camp LN
Gulfport, MS 39503-6245
Phone (228) 223-7250

Other practice location 1

3401 Main St
Moss Point, MS 39563-5101
Phone (731) 394-1145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251028000723 MS Practitioner - Nurse Practitioner 9739678004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

3401 Main St
Moss Point, MS 39563-5101
Phone (731) 394-1145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906968MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health LLC CurrentSince Oct 16, 2025 Accepting new patients
Bradford River Bend, LLC Past Accepting new patients
Bradford River Bend, LLC Past Accepting new patients

Locations

156 E Walnut Ave
Eupora, MS 39744
Phone (662) 258-8293

1220 E Northside Dr
Ste 170
Jackson, MS 39211
Phone (601) 613-6268

3401 Main St
Moss Point, MS 39563
Phone (228) 762-7451

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1972320604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15020 CAMP LN",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395036245",
            "telephone_number": "228-223-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15020 CAMP LN",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395036245",
            "telephone_number": "228-223-7250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Main St",
            "address_purpose": "LOCATION",
            "city": "Moss Point",
            "state": "MS",
            "postal_code": "395635101",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-24",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.