| Centerwell Senior Primary Care Ms Pc | |
|
2650 Beach Blvd Ste 40 Biloxi MS 39531-4517 | |
| (228) 273-4611 | |
| (877) 258-1526 |
| Full Name | Centerwell Senior Primary Care Ms Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2650 Beach Blvd Ste 40, Biloxi, Mississippi |
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerwell Senior Primary Care Ms Pc 6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | Centerwell Senior Primary Care Ms Pc 2650 Beach Blvd Ste 40 Biloxi MS 39531-4517 Ph: (228) 273-4611 |
| NPI Number | 1841902830 |
|---|---|
| Provider Enumeration Date | 12/21/2022 |
| Last Update Date | 07/03/2024 |
| Medicare PECOS PAC ID | 0143694190 |
|---|---|
| Medicare Enrollment ID | O20230315000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841902830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lara J Teal Clement |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912933672 PECOS PAC ID: 9032198858 Enrollment ID: I20040715000949 |
| Provider Name | Patrick S Bynum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437179967 PECOS PAC ID: 4486610151 Enrollment ID: I20041203000870 |
| Provider Name | Rasheda Jordan Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790072288 PECOS PAC ID: 1254577935 Enrollment ID: I20130425000223 |
| Provider Name | Michael Bookhardt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881034254 PECOS PAC ID: 3870817778 Enrollment ID: I20160929000145 |
| Provider Name | Lauren Gaters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861969305 PECOS PAC ID: 4385998046 Enrollment ID: I20181115000941 |
| Provider Name | Ashley Croom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295396661 PECOS PAC ID: 5496183170 Enrollment ID: I20200311000945 |
| Provider Name | Tracy S Sanford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346356862 PECOS PAC ID: 3678653508 Enrollment ID: I20211210002412 |
| Provider Name | Mitchell A Sanford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346726098 PECOS PAC ID: 7719302975 Enrollment ID: I20211213002807 |
| Provider Name | Timothy H Sanford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992819197 PECOS PAC ID: 9335229269 Enrollment ID: I20211213002828 |
| Provider Name | Erika D Redd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902471006 PECOS PAC ID: 8426438433 Enrollment ID: I20220708000849 |
| Provider Name | Earl Kyle Magee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508887977 PECOS PAC ID: 9537152475 Enrollment ID: I20230315000600 |
| Provider Name | Michaela Cheyenne Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386269629 PECOS PAC ID: 3476930793 Enrollment ID: I20230413002675 |
| Provider Name | Colleen Ann Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114532314 PECOS PAC ID: 1951777184 Enrollment ID: I20230725004233 |
| Provider Name | Madison Cochie Talton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194284430 PECOS PAC ID: 9234544750 Enrollment ID: I20240814003205 |
Medical Foundation Of South Ms Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2771 Pass Rd, Suite B, Biloxi, MS 39531 Phone: 228-385-4645 Fax: 228-385-4695 | |
Healthstop Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2490 Pass Rd, Biloxi, MS 39531 Phone: 228-207-9967 Fax: 228-273-1532 | |
Taylor Made Counseling Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 232 Eisenhower Dr Ste B, Biloxi, MS 39531 Phone: 601-688-4118 Fax: 228-220-4226 | |
Geographic Medicine Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 Debuys Rd., 215, Biloxi, MS 39531 Phone: 228-594-6484 Fax: 228-594-6494 | |
Regional Digestive Specialists, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15012 Lemoyne Blvd, Biloxi, MS 39532 Phone: 228-392-5787 Fax: 228-354-9169 | |
Ochsner Mississippi, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2781 C T Switzer Sr Dr Ste 302, Biloxi, MS 39531 Phone: 228-388-4816 Fax: 228-388-5906 | |
Painstop Spine Clinic, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 180 Debuys Rd, Biloxi, MS 39531 Phone: 228-273-4096 Fax: 228-594-1765 |