NPIMap

Organization Active NPI

Gulf Coast Children's Clinic

  • Pediatrics Physician
  • Ocean Springs, MS
National Provider Identifier
1992154025
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GULF COAST CHILDREN'S CLINIC
Practice address
3650 Groveland Rd
Ocean Springs, MS 39564-5754
Phone
(228) 875-0780
Fax
(228) 875-1009
NPI assigned
Jun 9, 2016
Last updated
Jun 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Meichelle Harvey
Title
Administrator
Phone
(228) 875-0780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

3650 Groveland Rd
Ocean Springs, MS 39564-5754

Mailing address

1720A Medical Park Dr
Suite 200
Biloxi, MS 39532-2129
Phone (228) 396-2726

Other identifiers 1

IdentifierTypeStateIssuer
05258597MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Gulf Coast Children's Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1720A Medical Park Dr
Ste 200
Biloxi, MS 39532
Phone (228) 354-0323

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1992154025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720A MEDICAL PARK DR",
            "address_2": "SUITE 200",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322129",
            "telephone_number": "228-396-2726",
            "fax_number": "228-875-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 GROVELAND RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645754",
            "telephone_number": "228-875-0780",
            "fax_number": "228-875-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST CHILDREN'S CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "MEICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "228-875-0780"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05258597",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.