1. Home
  2. Directory
  3. Mississippi
  4. Gulfport
  5. Specialist
  6. NPI Profile

GULF SOUTH PEDIATRIC CARDIOLOGY, LLC
NPI 1073653903
Specialist in Gulfport, MS

Active since February 08, 2007
4500 13TH ST, 611 BROAD AVENUE, GULFPORT, MS 39501(228) 868-7046(228) 575-2120 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gulf South Pediatric Cardiology, Llc NPPES

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

GULF SOUTH PEDIATRIC CARDIOLOGY, LLC (NPI 1073653903) is a healthcare organization registered as a specialist in Gulfport, Mississippi and active in the NPI registry since February 2007. The organization lists Lisa Ann Goodwin, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1073653903
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameGULF SOUTH PEDIATRIC CARDIOLOGY, LLC
Location Address4500 13TH ST, 611 BROAD AVENUEGulfport, MS 39501-2515
Mailing Address4500 13th St, 611 Broad AvenueGulfport, MS 39501-2515 · (228) 868-7046 · Fax (228) 575-2120
Phone(228) 868-7046
Fax(228) 575-2120
Organization SubpartNo
Authorized OfficialLisa Ann GoodwinPractice Manager · (228) 868-7046
Enumeration DateFebruary 8, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1073653903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
4500 13TH ST, Gulfport, MS 39501
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Gulf South Pediatric Cardiology, LLC's NPI number?

The NPI number for Gulf South Pediatric Cardiology, LLC is 1073653903. It was assigned to this organization in the NPPES registry on February 8, 2007.

Where is Gulf South Pediatric Cardiology, LLC located?

Gulf South Pediatric Cardiology, LLC is located at 4500 13th St 611 Broad Avenue, Gulfport, MS 39501. The listed phone number is (228) 868-7046.

What is Gulf South Pediatric Cardiology, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Gulf South Pediatric Cardiology, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.