MEMORIAL STONE COUNTY MEDICAL CENTER
NPI 1104477710
Family Medicine in Wiggins, MS

Active since September 25, 2019CLIA 25D1028769 · Waiver
1440 CENTRAL AVE E, WIGGINS, MS 39577(601) 928-6600(601) 928-6610 Get Directions Write a Review

NPPES record last updated: January 9, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Memorial Stone County Medical Center NPPES

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

MEMORIAL STONE COUNTY MEDICAL CENTER (NPI 1104477710) is a healthcare organization registered as a family medicine in Wiggins, Mississippi and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through March 31, 2028 and lists Peggy Lorraine Noonan, Physician Business Services Dir., as its authorized official.

NPPES Registry Identity

NPI1104477710
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMEMORIAL HOSPITAL AT GULFPORT
Location Address1440 CENTRAL AVE EWiggins, MS 39577-9602
Mailing Address1440 Central Ave EWiggins, MS 39577-9602 · (601) 928-6600 · Fax (601) 928-6610
Fax(601) 928-6610
Organization SubpartNo
Authorized OfficialPeggy Lorraine NoonanPhysician Business Services Dir. · (228) 575-1740
Enumeration DateSeptember 25, 2019
Last NPPES UpdateJanuary 9, 2024
NPPES CertifiedJanuary 9, 2024
✔ NPI 1104477710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1440 CENTRAL AVE E, Wiggins, MS 39577

Other Names 1

Doing Business AsMemorial Stone County Medical Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Memorial Stone County Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMississippiEnrollment IDO20080515000774Part A · HospitalDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

729

Medicare enrollment records show 729 clinicians reassign Medicare billing to Memorial Stone County Medical Center, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 10 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 47

Nurse Practitioner269
Certified Registered Nurse Anesthetist (CRNA)57
Internal Medicine57
Emergency Medicine49
Family Practice36
Obstetrics/Gynecology34
Pediatric Medicine27
Anesthesiology25
39 other specialties175

Nearest to this location (20)

See all 729
Nurse Practitioner
NPI 1801568639
1440 CENTRAL AVE E
Wiggins, MS 39577
(601) 928-6700
✔ PECOS✔ Accepts MedicareSame address
Podiatry
NPI 1376783324
1434 CENTRAL AVE E
Wiggins, MS 39577
(601) 928-6700
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1114481488
1434 CENTRAL AVE E
Wiggins, MS 39577
(601) 928-6600
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1386125383
1434 CENTRAL AVE E
Wiggins, MS 39577
(601) 928-6600
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1235553462
1440 CENTRAL AVE E
Wiggins, MS 39577
(601) 928-6700
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1346355583
975 HALL ST
Wiggins, MS 39577
(601) 528-9119
✔ PECOS✔ Accepts Medicare1.5 mi
Nurse Practitioner
NPI 1922381466
975 HALL ST
Wiggins, MS 39577
(601) 528-9119
✔ PECOS✔ Accepts Medicare1.7 mi
Family Practice
NPI 1689057721
1428 AZALEA DR S
Wiggins, MS 39577
(601) 928-9674
✔ PECOS✔ Accepts Medicare3.6 mi
Family Practice
NPI 1225043599
1428 AZALEA DR S
Wiggins, MS 39577
(601) 928-9674
✔ PECOS✔ Accepts Medicare3.6 mi
Nurse Practitioner
NPI 1669068136
61 JIM BOWDEN RD
Mc Henry, MS 39561
(228) 697-3796
✔ PECOS✔ Accepts Medicare9.0 mi
Nurse Practitioner
NPI 1427349273
6230 HIGHWAY 53
Poplarville, MS 39470
(601) 408-0916
✔ PECOS✔ Accepts Medicare23 mi
Nurse Practitioner
NPI 1376815134
302 HIGHWAY 11 S
Poplarville, MS 39470
(601) 403-8283
✔ PECOS✔ Accepts Medicare25 mi
Emergency Medicine
NPI 1972596567
12057 DELMAR PLAZA
Gulfport, MS 39503
(228) 897-5185
✔ PECOS26 mi
Qualified Speech Language Pathologist
NPI 1508177726
12303 HIGHWAY 49
Gulfport, MS 39503
(228) 832-6221
26 mi
Internal Medicine
NPI 1104238153
12330 ASHLEY DR
Gulfport, MS 39503
(228) 831-1572
✔ PECOS✔ Accepts Medicare26 mi
Allergy/Immunology
NPI 1063527356
12100 HIGHWAY 49
Gulfport, MS 39503
(228) 867-5185
✔ PECOS✔ Accepts Medicare27 mi
Clinical Social Worker
NPI 1396883310
11150 HIGHWAY 49N
Gulfport, MS 39503
(228) 575-1000
✔ PECOS28 mi
Critical Care (Intensivists)
NPI 1730507096
15190 COMMUNITY RD STE 110
Gulfport, MS 39503
(228) 539-3356
✔ PECOS✔ Accepts Medicare28 mi
Anesthesiology
NPI 1073975017
15190 COMMUNITY RD
Gulfport, MS 39503
(228) 575-7290
✔ PECOS✔ Accepts Medicare28 mi
Pulmonary Disease
NPI 1972530335
15190 COMMUNITY RD SUITE 220
Gulfport, MS 39503
(228) 539-3356
✔ PECOS✔ Accepts Medicare28 mi
See all 729 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Waiver 25D1028769

Memorial Stone County Medical Center · Wiggins, MS
Active · expires Mar 31, 2028
CLIA Number25D1028769
Laboratory TypeRural Health Clinic
Certificate Effective DateApril 1, 2026
Certificate Expiration DateMarch 31, 2028
Laboratory DirectorAshley Ross
Laboratory Phone(601) 928-6600
Laboratory LocationMemorial Stone County Medical Center1440 East Central Ave, Wiggins, MS 39577
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1104477710. It was assigned to this organization in the NPPES registry on September 25, 2019. The provider is doing business as Memorial Stone County Medical Center.

Where is Memorial Hospital At Gulfport located?

Memorial Hospital At Gulfport is located at 1440 Central Ave E, Wiggins, MS 39577. The listed phone number is (601) 928-6600.

What is Memorial Hospital At Gulfport's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Memorial Hospital At Gulfport enrolled in Medicare?

Yes. Memorial Hospital At Gulfport is registered in the Medicare PECOS enrollment system.

When is Memorial Hospital At Gulfport's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Mississippi, Hospital) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Memorial Hospital At Gulfport?

According to the CMS Revalidation Reassignment List (October 2026 release), 729 clinicians in 47 Medicare specialties reassign their Medicare billing to Memorial Hospital At Gulfport. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (269), Certified Registered Nurse Anesthetist (CRNA) (57) and Internal Medicine (57). Of these, 5 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Memorial Hospital At Gulfport hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D1028769) is associated with this NPI, valid through March 31, 2028. 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 Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, 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.