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MEMORIAL HOSPITAL AT GULFPORT
NPI 1073606901
General Acute Care Hospital in Gulfport, MS

Active since October 02, 2006CLIA 25D0991852 · Accreditation
4500 13TH ST, GULFPORT, MS 39501(228) 867-3076(228) 865-3098 Get Directions Write a Review

NPPES record last updated: January 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 7, 2021, Dec 4, 2019 (2 updates tracked since 2019).

About Memorial Hospital At Gulfport NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEMORIAL HOSPITAL AT GULFPORT (NPI 1073606901) is a healthcare organization registered as a general acute care hospital in Gulfport, Mississippi and active in the NPI registry since October 2006. The organization holds an CLIA Accreditation certificate valid through May 18, 2027, maintains a secondary practice location in Wiggins, and lists Kent Nicaud, Ceo, as its authorized official.

NPPES Registry Identity

NPI1073606901
Entity TypeOrganization
Primary Taxonomy282N00000X
Legal Business NameMEMORIAL HOSPITAL AT GULFPORT
Location Address4500 13TH STGulfport, MS 39501-2515
Mailing AddressPo Box 1810Gulfport, MS 39502-1810 · (228) 867-3076 · Fax (228) 865-3098
Phone(228) 867-3076
Fax(228) 865-3098
Organization SubpartNo
Authorized OfficialKent NicaudCeo · (228) 865-3076
Enumeration DateOctober 2, 2006
Last NPPES UpdateJanuary 9, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2024
✔ NPI 1073606901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care HospitalHospitals
Taxonomy Code282N00000X
Definition
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.
4500 13TH ST, Gulfport, MS 39501
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Secondary Practice Location 1

Location 11434 Central Ave EWiggins, MS 39577-9602 · Phone (601) 928-6600

Other Identifiers 13

Medicaid00020027MS
Medicaid000260081XGA
Medicaid1943061LA
MedicaidMEM0019NAL
Medicaid1731625LA
Medicaid901382200FL
OtherCA1177MS · Railroad Medicare
Other027MS · Blue Cross Blue Shield Ms
Medicaid1887007TN
Medicaid0250019TN
Other374535800MS · Us Dept Of Labor Number
OtherC00042MS · Cahaba Provider Number
Other000019027MS · Blue Cross

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 25D0991852

Memorial Hospital At Gulfport Dba Memorial Hospital At Stone County · Wiggins, MS
Active · expires May 18, 2027
CLIA Number25D0991852
Laboratory TypeHospital
Certificate Effective DateMay 19, 2025
Certificate Expiration DateMay 18, 2027
Laboratory DirectorDr. Matthew Safley
Laboratory Phone(601) 928-6645
Laboratory LocationMemorial Hospital At Gulfport Dba Memorial Hospital At Stone County1434 East Central Avenue, Wiggins, MS 39577
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER LYN JEFFREY
Nurse Practitioner
4500 13TH ST
GULFPORT, MS 39501
Harrison County (228) 867-4000
JASON WELLS CRNA
Nurse Anesthetist, Certified Registered
4500 13TH ST
GULFPORT, MS 39501
Harrison County (228) 865-3281
MRS. CARLA ANN RUSHING AGACNP
Nurse Practitioner (Acute Care)
4500 13TH ST
GULFPORT, MS 39501
Harrison County (228) 867-4000
TONI-ANN MILLER NP
Nurse Practitioner (Acute Care)
4500 13TH ST
GULFPORT, MS 39501
Harrison County (228) 867-4000
MS. TIFFANY S SCATLIFFE CSFA
Physician Assistant (Surgical)
4500 13TH ST
GULFPORT, MS 39501
Harrison County (228) 867-4000
STANLEY TURNER CRNA
Anesthesiology
4500 13TH ST
GULFPORT, MS 39501
Harrison County (228) 818-0563
MRS. JULIE KERSH APPEL RD
Dietitian, Registered
4500 13TH ST
GULFPORT, MS 39501
Harrison County (228) 867-4054
DAVIS HUTTO CRNA
Anesthesiology
4500 13TH ST
GULFPORT, MS 39501
Harrison County (228) 818-0563

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Memorial Hospital At Gulfport's NPI number?

The NPI number for Memorial Hospital At Gulfport is 1073606901. It was assigned to this organization in the NPPES registry on October 2, 2006.

Where is Memorial Hospital At Gulfport located?

Memorial Hospital At Gulfport is located at 4500 13th St, Gulfport, MS 39501. The listed phone number is (228) 867-3076.

What is Memorial Hospital At Gulfport's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

Does Memorial Hospital At Gulfport hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 25D0991852) is associated with this NPI, valid through May 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Memorial Hospital At Gulfport accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Memorial Hospital At Gulfport as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Memorial Hospital At Gulfport was last updated on January 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.