NPIMap

Individual provider Active NPI

Elizabeth Crosby Coleman, AGACNP-FNP-BC

  • Acute Care Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1972910230
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
R884282 Issued in MS
Practice address
1391 Broad Ave
Gulfport, MS 39501-2419
Phone
(228) 863-8868
Fax
(228) 863-8956
NPI assigned
Jul 18, 2014
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R884282 MS Primary

Addresses

Primary practice location

1391 Broad Ave
Gulfport, MS 39501-2419

Mailing address

1391 Broad Ave
Gulfport, MS 39501-2419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150706000500 MS Practitioner - Nurse Practitioner 3274845268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

1391 Broad Ave
Suite a
Gulfport, MS 39501-2419
Phone (228) 863-8868

1397 Broad Ave
Gulfport, MS 39501-2419
Phone (228) 575-1945

1756 Popps Ferry Rd
Biloxi, MS 39532-2118

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-3152

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince May 17, 2015 Accepting new patients
Southern Ms Heart Center,PA CurrentSince Aug 12, 2019 Accepting new patients
Southern Ms Heart Center,PA CurrentSince Aug 12, 2019 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1756 Popps Ferry Rd
Ste A
Biloxi, MS 39532
Phone (228) 865-3200

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

3704 Bienville Blvd
#B
Ocean Springs, MS 39564
Phone (228) 872-4040

4300 Hospital St
Ste 102
Pascagoula, MS 39581
Phone (228) 372-8270

Interoperability endpoints

  • Direct secure messaging: edrummond@direct.mhg.com

Organizations & group practices 6

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.

Hospital & facility affiliations 60

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1972910230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012419",
            "fax_number": "228-863-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1391 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012419",
            "telephone_number": "228-863-8868",
            "fax_number": "228-863-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "ELIZABETH",
        "middle_name": "CROSBY",
        "credential": "AGACNP-FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R884282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.