| Singing River Gulfport | |
|
15190 Community Rd Gulfport MS 39503-3485 | |
| (228) 575-7975 | |
| Not Available |
| Full Name | Singing River Gulfport |
|---|---|
| Speciality | Clinic/Center |
| Location | 15190 Community Rd, Gulfport, Mississippi |
| Authorized Official Name and Position | Charlie Brinkley (CFO) |
| Authorized Official Contact | 2284977597 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Singing River Gulfport 2101 Highway 90 Gautier MS 39553-5340 Ph: () - | Singing River Gulfport 15190 Community Rd Gulfport MS 39503-3485 Ph: (228) 575-7975 |
| NPI Number | 1861010159 |
|---|---|
| Provider Enumeration Date | 07/13/2020 |
| Last Update Date | 07/13/2020 |
| Medicare PECOS PAC ID | 5294154829 |
|---|---|
| Medicare Enrollment ID | O20201001001497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861010159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | William L Mcmahan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316002587 PECOS PAC ID: 8820986995 Enrollment ID: I20040309001237 |
| Provider Name | Gregory Patino |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548311103 PECOS PAC ID: 3577452242 Enrollment ID: I20040311000747 |
| Provider Name | Ronald E Myers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184751844 PECOS PAC ID: 5799677068 Enrollment ID: I20040330000291 |
| Provider Name | Bharat Sangani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922102219 PECOS PAC ID: 7517950553 Enrollment ID: I20040406000859 |
| Provider Name | Patricia Dawn Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881702231 PECOS PAC ID: 2466434360 Enrollment ID: I20040603001362 |
| Provider Name | Jerrod Taylor |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1427154327 PECOS PAC ID: 4486632155 Enrollment ID: I20040907001163 |
| Provider Name | Clara L Grace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306873450 PECOS PAC ID: 6800868704 Enrollment ID: I20040921001118 |
| Provider Name | Lennon E Bowen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619919156 PECOS PAC ID: 2163487174 Enrollment ID: I20041201000214 |
| Provider Name | James E Clarkson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1285711978 PECOS PAC ID: 9133177678 Enrollment ID: I20050111000582 |
| Provider Name | John D Patterson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194880419 PECOS PAC ID: 9638120249 Enrollment ID: I20050201000445 |
| Provider Name | Laurie S Patterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053354266 PECOS PAC ID: 6800833625 Enrollment ID: I20050413000835 |
| Provider Name | Tricia K Aultman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346322880 PECOS PAC ID: 9335183029 Enrollment ID: I20050614000486 |
| Provider Name | Rene Chinn-lang |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215992623 PECOS PAC ID: 5193776748 Enrollment ID: I20051110000246 |
| Provider Name | Curtis A Broussard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447248661 PECOS PAC ID: 4082634415 Enrollment ID: I20051130000840 |
| Provider Name | Tamara W Harper |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922068584 PECOS PAC ID: 3173532843 Enrollment ID: I20060410000140 |
| Provider Name | William Evans |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619913761 PECOS PAC ID: 0648274639 Enrollment ID: I20060906000057 |
| Provider Name | Oliver Waldrop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205879475 PECOS PAC ID: 9537163530 Enrollment ID: I20060906000185 |
| Provider Name | John D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114021359 PECOS PAC ID: 4789680323 Enrollment ID: I20061004000663 |
| Provider Name | Eric J Letonoff |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306872171 PECOS PAC ID: 9133120231 Enrollment ID: I20070116000175 |
| Provider Name | Clinton E Hull |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437232717 PECOS PAC ID: 8729021670 Enrollment ID: I20070123000189 |
| Provider Name | Andrew Marsh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548270721 PECOS PAC ID: 4789589763 Enrollment ID: I20070205000546 |
| Provider Name | Juanita S Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902961055 PECOS PAC ID: 9638272230 Enrollment ID: I20070320000654 |
| Provider Name | Muzaffar Piracha |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1912950320 PECOS PAC ID: 2961500228 Enrollment ID: I20070611000101 |
| Provider Name | Brandi R Garris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073630307 PECOS PAC ID: 8022117472 Enrollment ID: I20070626000192 |
| Provider Name | Michael David Larochelle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740228253 PECOS PAC ID: 6901988096 Enrollment ID: I20080129000100 |
| Provider Name | Stephen T Mcdavid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013958644 PECOS PAC ID: 9032115969 Enrollment ID: I20080225000342 |
| Provider Name | Jordan M Pastorek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265400634 PECOS PAC ID: 2163498569 Enrollment ID: I20080303000466 |
| Provider Name | Richard Huff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487708756 PECOS PAC ID: 4789762766 Enrollment ID: I20080416000071 |
| Provider Name | Cherryl D Purvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386772283 PECOS PAC ID: 7911918149 Enrollment ID: I20080605000303 |
| Provider Name | Leah Mcmahan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023287349 PECOS PAC ID: 3173693801 Enrollment ID: I20080605000890 |
| Provider Name | John Bailey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770794190 PECOS PAC ID: 9133290687 Enrollment ID: I20080611000477 |
| Provider Name | Tabitha S Bond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578734166 PECOS PAC ID: 4587736624 Enrollment ID: I20080707000055 |
| Provider Name | Nancy A Buckheister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396922423 PECOS PAC ID: 0941373047 Enrollment ID: I20080723000297 |
| Provider Name | Larry H Killebrew |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265514301 PECOS PAC ID: 5193879195 Enrollment ID: I20090810000544 |
| Provider Name | Ekow E Acquah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013922814 PECOS PAC ID: 6901971100 Enrollment ID: I20090819000582 |
| Provider Name | Timothy B Skelton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598867350 PECOS PAC ID: 0648325498 Enrollment ID: I20090901000319 |
| Provider Name | Bret A Waters |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740415074 PECOS PAC ID: 6305983263 Enrollment ID: I20091026000303 |
| Provider Name | Mahmoud H Zayed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699790196 PECOS PAC ID: 2062506652 Enrollment ID: I20100104000419 |
| Provider Name | Jennifer L Jurich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366774879 PECOS PAC ID: 5597896456 Enrollment ID: I20100622000331 |
| Provider Name | Deanna S Fernandez |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477876811 PECOS PAC ID: 4082745823 Enrollment ID: I20100623000514 |
| Provider Name | John P Pavlov |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124179791 PECOS PAC ID: 1759414766 Enrollment ID: I20100728000252 |
| Provider Name | Juliet W Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053554808 PECOS PAC ID: 2466585310 Enrollment ID: I20100729000679 |
| Provider Name | Jeremy J Simpler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528249554 PECOS PAC ID: 5890849319 Enrollment ID: I20100803001088 |
| Provider Name | Jason L Black |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508029083 PECOS PAC ID: 6103959333 Enrollment ID: I20100809000382 |
| Provider Name | Robert M Cromer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609831650 PECOS PAC ID: 3476678822 Enrollment ID: I20100909000203 |
| Provider Name | Christopher P Karcher |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1194810408 PECOS PAC ID: 4789740754 Enrollment ID: I20101020000780 |
| Provider Name | Sardar I Babar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1821194713 PECOS PAC ID: 1355302894 Enrollment ID: I20101027000335 |
| Provider Name | Edward I Dvorak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902820525 PECOS PAC ID: 0345434171 Enrollment ID: I20101104001624 |
| Provider Name | John D Bailey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427063791 PECOS PAC ID: 1951595784 Enrollment ID: I20101104001648 |
| Provider Name | William T Avara |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326062969 PECOS PAC ID: 0941494793 Enrollment ID: I20101105000123 |
| Provider Name | Martin Senitko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396952271 PECOS PAC ID: 0749371086 Enrollment ID: I20101201000239 |
| Provider Name | Lisa L Wilkerson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366579047 PECOS PAC ID: 2860689890 Enrollment ID: I20101203000080 |
| Provider Name | Kevin Hendry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417148917 PECOS PAC ID: 6204023807 Enrollment ID: I20101208000919 |
| Provider Name | Ronald D Rinker |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740226117 PECOS PAC ID: 9133132913 Enrollment ID: I20101209000672 |
| Provider Name | Catherine Pearl Hirsch |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598795171 PECOS PAC ID: 8224041009 Enrollment ID: I20101216000483 |
| Provider Name | Jeffrey Tipton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316257116 PECOS PAC ID: 9830388776 Enrollment ID: I20110107000881 |
| Provider Name | Joseph Lasserre |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982731733 PECOS PAC ID: 9032399530 Enrollment ID: I20110215000527 |
| Provider Name | Michel R Brown |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114052552 PECOS PAC ID: 9032390323 Enrollment ID: I20110218000872 |
| Provider Name | Richard A Seigler |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134180615 PECOS PAC ID: 3476562927 Enrollment ID: I20110323000089 |
| Provider Name | Jerilyn D Farmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366749152 PECOS PAC ID: 7416130638 Enrollment ID: I20110325000480 |
| Provider Name | Bradley Alan Paetz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770634966 PECOS PAC ID: 0042495228 Enrollment ID: I20110503000753 |
| Provider Name | Randy C Roth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013068212 PECOS PAC ID: 7911810056 Enrollment ID: I20110503000773 |
| Provider Name | John Swetnam Weldon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538210737 PECOS PAC ID: 2365628195 Enrollment ID: I20110512000344 |
| Provider Name | Jillian M Strayham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356646772 PECOS PAC ID: 9234315599 Enrollment ID: I20110520000600 |
| Provider Name | Matthew B Carroll |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1124247341 PECOS PAC ID: 4981880168 Enrollment ID: I20110524000601 |
| Provider Name | Edwina I Roland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194017509 PECOS PAC ID: 7810174661 Enrollment ID: I20110606000216 |
| Provider Name | Suzanne Ayers Iodice |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013069020 PECOS PAC ID: 5597942961 Enrollment ID: I20110613000244 |
| Provider Name | Jason Payne |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477723252 PECOS PAC ID: 5698943868 Enrollment ID: I20110714000665 |
| Provider Name | John Ryan Logan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801059381 PECOS PAC ID: 5597933176 Enrollment ID: I20110726000641 |
| Provider Name | Erica M Frank |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326093915 PECOS PAC ID: 0749218766 Enrollment ID: I20110812000448 |
| Provider Name | Edward M Gaber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962406298 PECOS PAC ID: 0143201871 Enrollment ID: I20110914000474 |
| Provider Name | Rolando S Barnes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295970721 PECOS PAC ID: 5395916431 Enrollment ID: I20110921000042 |
| Provider Name | Selena Lee Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427353283 PECOS PAC ID: 4789855818 Enrollment ID: I20110922000136 |
| Provider Name | Tracey R Hammack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710144571 PECOS PAC ID: 4082785985 Enrollment ID: I20111206000674 |
| Provider Name | Drew Steven Weber |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326211475 PECOS PAC ID: 3375718786 Enrollment ID: I20111214000326 |
| Provider Name | Domonique Nikki Cochran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861761348 PECOS PAC ID: 6305013756 Enrollment ID: I20120125000741 |
| Provider Name | Diana D Gilbert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346402617 PECOS PAC ID: 1153588330 Enrollment ID: I20120130000749 |
| Provider Name | Christine C Bowman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134425044 PECOS PAC ID: 9931366762 Enrollment ID: I20120207000503 |
| Provider Name | Chad H Cochran |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609157502 PECOS PAC ID: 1850558586 Enrollment ID: I20120207000609 |
| Provider Name | Jason Sanders Fontan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124170451 PECOS PAC ID: 5698932028 Enrollment ID: I20120213000603 |
| Provider Name | Charles R Frye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740331099 PECOS PAC ID: 7214194661 Enrollment ID: I20120213000750 |
| Provider Name | Clyde Michael Jones |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1477557064 PECOS PAC ID: 0042105066 Enrollment ID: I20120313000758 |
| Provider Name | Stuart L Phillips |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275763823 PECOS PAC ID: 1456547975 Enrollment ID: I20120327000425 |
| Provider Name | Amie Lynn Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104198266 PECOS PAC ID: 1759541428 Enrollment ID: I20120404000771 |
| Provider Name | Robin G Viglianco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275891699 PECOS PAC ID: 9739345935 Enrollment ID: I20120716000215 |
| Provider Name | Nicholas J Fayard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114126042 PECOS PAC ID: 6800052275 Enrollment ID: I20120730000712 |
| Provider Name | Eric Vincent Plott |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346466596 PECOS PAC ID: 3072643899 Enrollment ID: I20130304000400 |
| Provider Name | Simal Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780859652 PECOS PAC ID: 2466622329 Enrollment ID: I20130419000208 |
| Provider Name | Brittain Cross |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699086918 PECOS PAC ID: 5193961787 Enrollment ID: I20130427000022 |
| Provider Name | Anthony T Tanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275804270 PECOS PAC ID: 4385805100 Enrollment ID: I20130723000319 |
| Provider Name | Ashley N Hilsabeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134495443 PECOS PAC ID: 8921264177 Enrollment ID: I20130913000389 |
| Provider Name | Nicole R Walton |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1013115906 PECOS PAC ID: 2062543234 Enrollment ID: I20130924000737 |
| Provider Name | Jatinder Pal Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245499953 PECOS PAC ID: 2466686068 Enrollment ID: I20131015001372 |
| Provider Name | Jillian Kimbrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275892705 PECOS PAC ID: 1254567605 Enrollment ID: I20131113002140 |
| Provider Name | Joseph Chance Keys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639510142 PECOS PAC ID: 4486880754 Enrollment ID: I20131114000703 |
| Provider Name | James K Campbell |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053331421 PECOS PAC ID: 1658356993 Enrollment ID: I20140110000228 |
| Provider Name | Julie M Messenger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275792848 PECOS PAC ID: 1052541943 Enrollment ID: I20140219001710 |
| Provider Name | Michael Rehor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326460122 PECOS PAC ID: 1355571415 Enrollment ID: I20140311001527 |
| Provider Name | Raymond P Blythe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700210432 PECOS PAC ID: 3577786706 Enrollment ID: I20140515001570 |
| Provider Name | Ashleigh Brooke Teates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467799494 PECOS PAC ID: 7618190786 Enrollment ID: I20140516001195 |
| Provider Name | Angela N Meadows |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679815609 PECOS PAC ID: 5092939074 Enrollment ID: I20140612002043 |
| Provider Name | Kit Chase Melton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851688162 PECOS PAC ID: 6901020361 Enrollment ID: I20140624002013 |
| Provider Name | Gregory Ryan Culpepper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598077059 PECOS PAC ID: 4789824327 Enrollment ID: I20140627001442 |
| Provider Name | Leanne C Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861747743 PECOS PAC ID: 9537386206 Enrollment ID: I20140805000516 |
| Provider Name | Hoyet Arlon Hand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225340599 PECOS PAC ID: 2769614312 Enrollment ID: I20140924000896 |
| Provider Name | Carla Ann Rushing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023417938 PECOS PAC ID: 8325361504 Enrollment ID: I20141218001914 |
| Provider Name | Wayne Driver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992194955 PECOS PAC ID: 8729302427 Enrollment ID: I20150129001770 |
| Provider Name | Jami D Lechner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992105191 PECOS PAC ID: 0446575104 Enrollment ID: I20150221000081 |
| Provider Name | Gregory R Myrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972786960 PECOS PAC ID: 9335335942 Enrollment ID: I20150305000767 |
| Provider Name | Amanda Yawn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760884373 PECOS PAC ID: 1456677475 Enrollment ID: I20150310000144 |
| Provider Name | Kim A Tumminello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649548892 PECOS PAC ID: 2860642998 Enrollment ID: I20150408000780 |
| Provider Name | Christopher A Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073851689 PECOS PAC ID: 3971748401 Enrollment ID: I20150413001715 |
| Provider Name | Jillian Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174913859 PECOS PAC ID: 7416269451 Enrollment ID: I20150706001957 |
| Provider Name | Tyler Dean Sexton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356607857 PECOS PAC ID: 5799925129 Enrollment ID: I20150730013338 |
| Provider Name | Laura Blanks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306192612 PECOS PAC ID: 6507170578 Enrollment ID: I20150804005432 |
| Provider Name | James Harwell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053345157 PECOS PAC ID: 0840252938 Enrollment ID: I20150911001103 |
| Provider Name | Nicholas Louis Pendleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518342963 PECOS PAC ID: 0749598100 Enrollment ID: I20151005000735 |
| Provider Name | James M Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659757870 PECOS PAC ID: 4981912185 Enrollment ID: I20151008001264 |
| Provider Name | Christopher L Smelley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134368939 PECOS PAC ID: 8527296953 Enrollment ID: I20151124000278 |
| Provider Name | Andrew Zielinski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073558185 PECOS PAC ID: 3678754322 Enrollment ID: I20151216002512 |
| Provider Name | James L Sullivan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437523958 PECOS PAC ID: 2668777889 Enrollment ID: I20160226000343 |
| Provider Name | Jamie Damico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982062170 PECOS PAC ID: 1850696725 Enrollment ID: I20160302000150 |
| Provider Name | Sidney Wayne Rushing |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902101330 PECOS PAC ID: 5395920607 Enrollment ID: I20160323000762 |
| Provider Name | Laura Ann Brandle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114385721 PECOS PAC ID: 7113226853 Enrollment ID: I20160429001591 |
| Provider Name | Brad Joseph Greenfield |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1336431436 PECOS PAC ID: 1355632282 Enrollment ID: I20160623000054 |
| Provider Name | Cory B Carter |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1609188911 PECOS PAC ID: 7315261914 Enrollment ID: I20160624000108 |
| Provider Name | Renee Shiao |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548586399 PECOS PAC ID: 0941592174 Enrollment ID: I20160708001503 |
| Provider Name | Christopher Bowen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720344583 PECOS PAC ID: 2365682622 Enrollment ID: I20160808000859 |
| Provider Name | Michael Knotts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912359415 PECOS PAC ID: 7416242888 Enrollment ID: I20160824001233 |
| Provider Name | David N Johnston |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417400896 PECOS PAC ID: 5193011427 Enrollment ID: I20160913000073 |
| Provider Name | Melody Horton-drummond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174908420 PECOS PAC ID: 9234423450 Enrollment ID: I20160926000604 |
| Provider Name | Jared Seymour |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639620883 PECOS PAC ID: 8426330762 Enrollment ID: I20170123001339 |
| Provider Name | Kenyada Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619419900 PECOS PAC ID: 7810279809 Enrollment ID: I20170127000705 |
| Provider Name | Amy Pontius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083159099 PECOS PAC ID: 9234412487 Enrollment ID: I20170213002387 |
| Provider Name | Tracie D George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629514286 PECOS PAC ID: 5698059657 Enrollment ID: I20170313000440 |
| Provider Name | Maggie E Duke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942747266 PECOS PAC ID: 7214212166 Enrollment ID: I20170316001025 |
| Provider Name | Jennifer Delaney-davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821537200 PECOS PAC ID: 9335425131 Enrollment ID: I20170410002242 |
| Provider Name | Alvin Joseph Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790224871 PECOS PAC ID: 4183991490 Enrollment ID: I20170608000456 |
| Provider Name | Lori Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467983601 PECOS PAC ID: 3173891637 Enrollment ID: I20170626000819 |
| Provider Name | Anna S Kahlmus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366989253 PECOS PAC ID: 3173895927 Enrollment ID: I20170815000818 |
| Provider Name | Traci White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316483084 PECOS PAC ID: 3870865504 Enrollment ID: I20170816000187 |
| Provider Name | Jody Juneau |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588623250 PECOS PAC ID: 3375559172 Enrollment ID: I20170816003829 |
| Provider Name | Ramon A Brown |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407148935 PECOS PAC ID: 2062644883 Enrollment ID: I20171120000647 |
| Provider Name | Truong V Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285155614 PECOS PAC ID: 4688931082 Enrollment ID: I20171120000947 |
| Provider Name | Donna Marie Burks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629589643 PECOS PAC ID: 0042577306 Enrollment ID: I20171122001129 |
| Provider Name | Daniel L Hollowell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710499751 PECOS PAC ID: 3577821834 Enrollment ID: I20171215000249 |
| Provider Name | Joshua Coker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457795684 PECOS PAC ID: 0941519284 Enrollment ID: I20171227002905 |
| Provider Name | Ashley Williams Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730694662 PECOS PAC ID: 7315207479 Enrollment ID: I20180209001031 |
| Provider Name | Glenda Darlene Balius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497262943 PECOS PAC ID: 0446512990 Enrollment ID: I20180320002838 |
| Provider Name | Jennie Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871096859 PECOS PAC ID: 6709141369 Enrollment ID: I20180531001799 |
| Provider Name | John J Hall |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700132545 PECOS PAC ID: 8628349040 Enrollment ID: I20180625003391 |
| Provider Name | Katelyn S Johnston |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669965505 PECOS PAC ID: 9335495258 Enrollment ID: I20180709000684 |
| Provider Name | Mary Lindsey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508208992 PECOS PAC ID: 5698061653 Enrollment ID: I20180720002821 |
| Provider Name | Subhas Sitaula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104175546 PECOS PAC ID: 0143577924 Enrollment ID: I20180725001553 |
| Provider Name | Asma Khader |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235511874 PECOS PAC ID: 9032429949 Enrollment ID: I20180813000596 |
| Provider Name | John H Bechtel |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1407844715 PECOS PAC ID: 9133016710 Enrollment ID: I20180813002085 |
| Provider Name | Mahmud Samra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558743062 PECOS PAC ID: 3678883055 Enrollment ID: I20180817002670 |
| Provider Name | Courtney Leigh Ponder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568948016 PECOS PAC ID: 8224387113 Enrollment ID: I20180827001755 |
| Provider Name | Techksell Mcknight Washington |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609070283 PECOS PAC ID: 7214107341 Enrollment ID: I20180924002688 |
| Provider Name | Nedal Matani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275997959 PECOS PAC ID: 5890047153 Enrollment ID: I20181015002084 |
| Provider Name | Kevin Thomas Schisler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093286551 PECOS PAC ID: 1658619184 Enrollment ID: I20190208000131 |
| Provider Name | Ashley Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720573959 PECOS PAC ID: 0648518183 Enrollment ID: I20190208000643 |
| Provider Name | Nhung Thi Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720550221 PECOS PAC ID: 2567700586 Enrollment ID: I20190215001999 |
| Provider Name | Wassem Juakiem |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508177387 PECOS PAC ID: 1759525900 Enrollment ID: I20190307001013 |
| Provider Name | Bradford Thomas Margherio |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598238578 PECOS PAC ID: 6002155926 Enrollment ID: I20190401001179 |
| Provider Name | Jessica I Strunk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972071611 PECOS PAC ID: 3779826763 Enrollment ID: I20190514002644 |
| Provider Name | Cyrena Nerissa Muffley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164983060 PECOS PAC ID: 0840528097 Enrollment ID: I20190826002299 |
| Provider Name | Andrew J. Barfield |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750793253 PECOS PAC ID: 9032448667 Enrollment ID: I20190907000104 |
| Provider Name | Philip D Myers |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003254525 PECOS PAC ID: 1951530096 Enrollment ID: I20190911003951 |
| Provider Name | Dipti Baral |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1275966137 PECOS PAC ID: 0446545438 Enrollment ID: I20190916000639 |
| Provider Name | Syed Abdullah Waheed |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1306286737 PECOS PAC ID: 3072815562 Enrollment ID: I20190917003651 |
| Provider Name | Jonathan White |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073865762 PECOS PAC ID: 5496906125 Enrollment ID: I20191016003720 |
| Provider Name | Lashaunda Whitley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295382828 PECOS PAC ID: 0244561579 Enrollment ID: I20191017000281 |
| Provider Name | Kyla Austin Richburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366083040 PECOS PAC ID: 8820420904 Enrollment ID: I20191111001838 |
| Provider Name | Jesse Moskowitz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619131125 PECOS PAC ID: 2567537954 Enrollment ID: I20191204000516 |
| Provider Name | Ryan A Anderson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093192726 PECOS PAC ID: 4385964196 Enrollment ID: I20191230000247 |
| Provider Name | Benjamin Dahlberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700231032 PECOS PAC ID: 7517238074 Enrollment ID: I20200122003107 |
| Provider Name | Michael A Finan |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1508813825 PECOS PAC ID: 6305879701 Enrollment ID: I20200330003736 |
| Provider Name | Adrian Reyes Bersabe |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1336432756 PECOS PAC ID: 6406179464 Enrollment ID: I20200401000809 |
| Provider Name | Trinh Thu Weatherly |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083265185 PECOS PAC ID: 4981033586 Enrollment ID: I20200402001740 |
| Provider Name | Caleb Andrew Peyton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760914246 PECOS PAC ID: 8729354139 Enrollment ID: I20200408004134 |
| Provider Name | Ross Pinson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902242035 PECOS PAC ID: 2668774597 Enrollment ID: I20200415000218 |
| Provider Name | Talha Nawaz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1639585094 PECOS PAC ID: 4789995655 Enrollment ID: I20200522001804 |
| Provider Name | Chelsey Lynn Hill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598299786 PECOS PAC ID: 6305115320 Enrollment ID: I20200618002488 |
| Provider Name | Hajra S Cheema |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609322361 PECOS PAC ID: 4789913211 Enrollment ID: I20200710000152 |
| Provider Name | Amy Lynn Scheller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255770558 PECOS PAC ID: 8921242140 Enrollment ID: I20200720001521 |
| Provider Name | Jacob Christopher Bessler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801329131 PECOS PAC ID: 3173899176 Enrollment ID: I20200727000599 |
| Provider Name | Christina Marie Daniel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811425945 PECOS PAC ID: 9931525086 Enrollment ID: I20200819002916 |
| Provider Name | Dustin R Bratton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760979884 PECOS PAC ID: 3779835657 Enrollment ID: I20201008000163 |
| Provider Name | Mohammed W Kaashmiri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184614992 PECOS PAC ID: 7012053242 Enrollment ID: I20201016001277 |
| Provider Name | Courtney Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457958910 PECOS PAC ID: 1052731668 Enrollment ID: I20201021000688 |
| Provider Name | Hillary Paige Saucier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811502628 PECOS PAC ID: 1759701097 Enrollment ID: I20201026001917 |
| Provider Name | Joseph M Cook |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700315686 PECOS PAC ID: 4284908328 Enrollment ID: I20201110002715 |
| Provider Name | Ariel N Fore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023629847 PECOS PAC ID: 1951711399 Enrollment ID: I20201113001028 |
| Provider Name | Bradley Goldenberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477595239 PECOS PAC ID: 8729121280 Enrollment ID: I20201123000475 |
| Provider Name | Michael Anthony Errico |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770897522 PECOS PAC ID: 0547480808 Enrollment ID: I20201124000131 |
| Provider Name | Lisa A Umphrey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164622486 PECOS PAC ID: 8426273921 Enrollment ID: I20201207002247 |
| Provider Name | William Berglind |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518228741 PECOS PAC ID: 6709041338 Enrollment ID: I20201217000548 |
| Provider Name | Kayla Grace Bosco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972109429 PECOS PAC ID: 1355754169 Enrollment ID: I20210114002160 |
| Provider Name | Krishna P Joshi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1164808168 PECOS PAC ID: 2769799097 Enrollment ID: I20210621003349 |
| Provider Name | Christal Sareda Fairley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073180063 PECOS PAC ID: 6103227400 Enrollment ID: I20210624000164 |
| Provider Name | Solly S. Chedid |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1972586188 PECOS PAC ID: 3072540921 Enrollment ID: I20210706002584 |
| Provider Name | Jennifer Hebert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174849269 PECOS PAC ID: 2860633120 Enrollment ID: I20210712002589 |
| Provider Name | Arica Q Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518535319 PECOS PAC ID: 0244633980 Enrollment ID: I20210719003427 |
| Provider Name | Cadi Samantha Atwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972173540 PECOS PAC ID: 0446654958 Enrollment ID: I20210805001880 |
| Provider Name | Anthony P Bertasi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528590346 PECOS PAC ID: 9234416397 Enrollment ID: I20210810001939 |
| Provider Name | Muhammad Razzaq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891287561 PECOS PAC ID: 9436480928 Enrollment ID: I20210814000226 |
| Provider Name | Zachary R Eagle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689166290 PECOS PAC ID: 7315281730 Enrollment ID: I20210818003577 |
| Provider Name | Shauna Brooke Stringer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477125169 PECOS PAC ID: 8527463645 Enrollment ID: I20210826002653 |
| Provider Name | Cynthia Dees Snow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467128553 PECOS PAC ID: 3870990146 Enrollment ID: I20210929002026 |
| Provider Name | Christopher Benton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518322098 PECOS PAC ID: 0446556781 Enrollment ID: I20211026003012 |
| Provider Name | Jason Keith Ely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104595396 PECOS PAC ID: 4082002548 Enrollment ID: I20211102002819 |
| Provider Name | Justin Ross Tillman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215543756 PECOS PAC ID: 0042608408 Enrollment ID: I20211104000404 |
| Provider Name | Robert Davee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811359540 PECOS PAC ID: 1557649985 Enrollment ID: I20211111000628 |
| Provider Name | Jacquelyn Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306518477 PECOS PAC ID: 0042609877 Enrollment ID: I20211116001422 |
| Provider Name | Aejaz Ul Haq |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1649652595 PECOS PAC ID: 2365832359 Enrollment ID: I20211206002896 |
| Provider Name | Jarrod Anthony Howell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770250334 PECOS PAC ID: 1951792647 Enrollment ID: I20220107001065 |
| Provider Name | Matthew J Murray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104238153 PECOS PAC ID: 0042513673 Enrollment ID: I20220122000084 |
| Provider Name | Gina Marie Guillotte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063163012 PECOS PAC ID: 3173915907 Enrollment ID: I20220127002340 |
| Provider Name | Charles Edward Jacocks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104321967 PECOS PAC ID: 0446501902 Enrollment ID: I20220211000157 |
| Provider Name | Susan M. Carbajal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376138859 PECOS PAC ID: 7113311879 Enrollment ID: I20220223002746 |
| Provider Name | Stephanie Denise Toche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720747256 PECOS PAC ID: 7012301203 Enrollment ID: I20220304000632 |
| Provider Name | Haleigh West Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982356929 PECOS PAC ID: 6103211735 Enrollment ID: I20220318000043 |
| Provider Name | Ryan T Layman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871947846 PECOS PAC ID: 2163717919 Enrollment ID: I20220409000105 |
| Provider Name | Rachael Courtney Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821745233 PECOS PAC ID: 6507252087 Enrollment ID: I20220410000072 |
| Provider Name | Abby Hoover Thibodeaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912652710 PECOS PAC ID: 5597151944 Enrollment ID: I20220412000344 |
| Provider Name | Adam M Peterson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659724177 PECOS PAC ID: 1951695691 Enrollment ID: I20220412000438 |
| Provider Name | Sheridan L Skarl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467487488 PECOS PAC ID: 3779589411 Enrollment ID: I20220413000446 |
| Provider Name | Stephanie Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437805538 PECOS PAC ID: 2769879188 Enrollment ID: I20220503001200 |
| Provider Name | Max Hensel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750878104 PECOS PAC ID: 3476940891 Enrollment ID: I20220503001282 |
| Provider Name | Zachary S Urick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497245112 PECOS PAC ID: 0648525360 Enrollment ID: I20220531000489 |
| Provider Name | Brett T. Grobman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578917217 PECOS PAC ID: 5597031401 Enrollment ID: I20220604000149 |
| Provider Name | Victor-mauricio Ordaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255893756 PECOS PAC ID: 3779813852 Enrollment ID: I20220713002690 |
| Provider Name | Chelsea Russell Eure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972232734 PECOS PAC ID: 3173905999 Enrollment ID: I20220726003124 |
| Provider Name | Jordan C Kirkland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962974022 PECOS PAC ID: 0244570844 Enrollment ID: I20220826001991 |
| Provider Name | Christopher Carey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932604022 PECOS PAC ID: 0749532919 Enrollment ID: I20220915001528 |
| Provider Name | Courtney C Shouse |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962004481 PECOS PAC ID: 6608280094 Enrollment ID: I20220917000344 |
| Provider Name | Lance Lavon Philyaw |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902300023 PECOS PAC ID: 5799016457 Enrollment ID: I20220924000209 |
| Provider Name | Lori Michelle Goodnight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649990144 PECOS PAC ID: 4284010356 Enrollment ID: I20220928000660 |
| Provider Name | Esmael Mayar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215497326 PECOS PAC ID: 5799179222 Enrollment ID: I20221007001476 |
| Provider Name | Priya Priyambada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649535519 PECOS PAC ID: 6204129760 Enrollment ID: I20221007001564 |
| Provider Name | Jamie Endt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245967918 PECOS PAC ID: 3971979691 Enrollment ID: I20221021000464 |
| Provider Name | Clinton T Seal |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700532041 PECOS PAC ID: 4183002207 Enrollment ID: I20221220000653 |
| Provider Name | Tabitha Shavonne Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124736038 PECOS PAC ID: 2668842576 Enrollment ID: I20230110000567 |
| Provider Name | George Michael Shahin |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1508278912 PECOS PAC ID: 3274855515 Enrollment ID: I20230126002813 |
| Provider Name | Susan Rojas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417673484 PECOS PAC ID: 5294107744 Enrollment ID: I20230209000119 |
| Provider Name | Jennifer Bosarge Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275256521 PECOS PAC ID: 2961874268 Enrollment ID: I20230215000712 |
| Provider Name | Jyothi Dodlapati |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1467402602 PECOS PAC ID: 3274421219 Enrollment ID: I20230322001288 |
| Provider Name | Mohammed Al-nufal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295155869 PECOS PAC ID: 7416322763 Enrollment ID: I20230419000444 |
| Provider Name | Cherie Champagne |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1720432107 PECOS PAC ID: 2567822893 Enrollment ID: I20230719000668 |
| Provider Name | Erum Zafar Malik |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1770969453 PECOS PAC ID: 0547517989 Enrollment ID: I20230901001811 |
| Provider Name | Olivia G Gennarelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124709126 PECOS PAC ID: 4587012588 Enrollment ID: I20231201001280 |
| Provider Name | Jasmine Renee Padgett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932668068 PECOS PAC ID: 5890026827 Enrollment ID: I20231214001324 |
| Provider Name | Christine Tracey Balius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073207817 PECOS PAC ID: 1850742594 Enrollment ID: I20240108003386 |
| Provider Name | Michael Turner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245764562 PECOS PAC ID: 5193096360 Enrollment ID: I20240112000377 |
| Provider Name | Arianna Mariam Mohiuddin |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1770977829 PECOS PAC ID: 9537464649 Enrollment ID: I20240124002543 |
Centerwell Senior Primary Care-gulfport Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12057 Highway 49 Ste C, Gulfport, MS 39503 Phone: 228-832-9385 Fax: 877-504-6444 | |
My Brother's Keeper, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 Bridge St, Gulfport, MS 39507 Phone: 769-216-2455 | |
Children's International, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15465 Oak Ln, Gulfport, MS 39503 Phone: 228-831-8800 Fax: 228-831-8020 | |
Coastal Family Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15024 Martin Luther King Jr Blvd, Gulfport, MS 39501 Phone: 228-864-0003 Fax: 228-374-0856 | |
Gulf Coast Endocrinology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4540 W Railroad St, Gulfport, MS 39501 Phone: 228-867-6062 Fax: 228-867-2598 | |
Physicians Clinic At Mhg Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12261 Highway 49, Suite 11 F, Gulfport, MS 39503 Phone: 228-867-5185 Fax: 228-867-5186 | |
Physicians Clinic At Mhg Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 13th St, Gulfport, MS 39501 Phone: 228-867-5201 Fax: 228-867-3152 |