Provider Type Icon

MEMORIAL HOSPITAL AT GULFPORT NPI 1932122017


NPI Information

NPI: 1932122017
Provider Name: MEMORIAL HOSPITAL AT GULFPORT
Classification: Psychologist - 103TB0200X
Entity Type: Organization

Specialization: Cognitive & Behavioral

CLIA Number: 25D0712213

Address:
11150 HIGHWAY 49N
GULFPORT, MS
ZIP 39503
Phone: (228) 575-1000
Get Directions

MEMORIAL HOSPITAL AT GULFPORT is a cognitive and behavioral psychologist in Gulfport, MS. The provider is a psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. MEMORIAL HOSPITAL AT GULFPORT NPI is 1932122017. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11150 HIGHWAY 49N
GULFPORT, MS
ZIP 39503
Phone: (228) 575-1000
Fax: (228) 575-2002

The provider's authorized official is Michael Zieman .
The authorized official title is Administrator and has the following contact phone number (228) 575-1907.

The CLIA number assigned to this NPI record is 25D0712213 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/26/2006 and was last updated on 5/5/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TB0200XPsychologistCognitive & BehavioralYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1512G700417MEDICARE UPINMISSISSIPPI
209015293MEDICAIDMISSISSIPPI
3512G700417MEDICARE PINMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.