LIVING WATERS COMMUNITY MEDICAL CENTER PLLC
NPI 1144403122
Specialist in Pass Christian, MS

Q: What is Living Waters Community Medical Center PLLC's specialty?

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

Active since December 12, 2007

13472 VIDALIA RD, PASS CHRISTIAN, MS 39571(228) 586-2455 Get Directions Write a Review

NPPES record last updated: December 12, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Living Waters Community Medical Center Pllc NPPES

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

LIVING WATERS COMMUNITY MEDICAL CENTER PLLC (NPI 1144403122) is a healthcare organization registered as a specialist in Pass Christian, Mississippi and active in the NPI registry since December 2007. The organization lists Lisa Marie Tillman, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1144403122

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameLIVING WATERS COMMUNITY MEDICAL CENTER PLLC

Location Address13472 VIDALIA RDPass Christian, MS 39571-8300

Mailing Address13472 Vidalia RdPass Christian, MS 39571-8300 · (228) 586-2455

Phone(228) 586-2455

Organization SubpartNo

Authorized OfficialLisa Marie TillmanOffice Manager · (228) 586-2455

Enumeration DateDecember 12, 2007

✔ NPI 1144403122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in MS · 06960

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.

13472 VIDALIA RD, Pass Christian, MS 39571

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Other Identifiers 1

Medicaid09015234MS

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

Other Providers at the Same Location NPPES 2

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

HEARTLAND PEDIATRICS LLC

Clinic/Center (Primary Care)

13472 VIDALIA RD
PASS CHRISTIAN, MS 39571

Harrison County (228) 344-0039

MEMORIAL HOSPITAL AT GULFPORT

Orthopaedic Surgery

13472 VIDALIA RD
PASS CHRISTIAN, MS 39571

Harrison County (228) 586-2455

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 Living Waters Community Medical Center PLLC's NPI number?

The NPI number for Living Waters Community Medical Center PLLC is 1144403122. It was assigned to this organization in the NPPES registry on December 12, 2007.

Where is Living Waters Community Medical Center PLLC located?

Living Waters Community Medical Center PLLC is located at 13472 Vidalia Rd, Pass Christian, MS 39571. The listed phone number is (228) 586-2455.

What is Living Waters Community Medical Center PLLC'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 Living Waters Community Medical Center PLLC was last updated on December 12, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.