Daniel Richard Damitio, NP-C
Individual provider Active NPI Family Nurse Practitioner · Biloxi, MS
NPI 1982180386 · NPPES record last updated Jul 18, 2018
Key facts
- NPI
- 1982180386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 902702 (MS)
- Practice address
- 2781 C T Switzer Sr Dr Ste 400
Biloxi, MS 39531-4535 - Phone
- (228) 388-4585
- NPI assigned
- Jul 18, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 60
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Coastal Family Health Center, Inc
Practice addresses (Care Compare)
715 A Division St
Biloxi, MS 39530-2209
Phone (229) 374-4991
Hospital & facility affiliations
- Memorial Hospital at Gulfport
- Memorial Hospital Biloxi
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181221001440 | MS | Practitioner - Nurse Practitioner | 9739424664 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 902702 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Family Health Center, Inc | Current |
Accepting new patients | |
| Coastal Family Health Center, Inc | Current |
Accepting new patients | |
| Coastal Family Health Center, Inc | Current | Accepting new patients |
Locations
715A Division St
Biloxi, MS 39530
Phone (228) 374-4991
1046 Division St
Biloxi, MS 39530
Phone (225) 374-2494
15024 Mlk
Gulfport, MS 39501
Phone (228) 846-0003
Interoperability endpoints
- daniel.damitio.p1@direct.cfhc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 902702 | MS | Yes |
Addresses
Primary practice location
2781 C T Switzer Sr Dr Ste 400
Biloxi, MS 39531-4535
Mailing address
2781 C T Switzer Sr Dr Ste 400
Biloxi, MS 39531-4535
Phone (228) 388-4585
Other providers in Biloxi, MS
- Mario Joseph Cuzzi III
- Tina M. Cvitanovich
- Keith Anthony D'Angelo
- D'Iberville Home Program, LLC
- Ben Dahlberg
- Lakin R Dammer
- Daniel J Vujnovich PLLC
- Irina Aleksandrovna Daniel
- Lauren Maria Daniel
- Roderick Eugene Daniel
All providers in Biloxi, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.