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MEMORIAL SURGERY CENTER CEDAR LAKE
NPI 1215546635
General Acute Care Hospital in Biloxi, MS

Active since July 31, 2020CLIA 25D2003015 · Waiver
1720B MEDICAL PARK DR, BILOXI, MS 39532(228) 702-2000(228) 702-2018 Get Directions Write a Review

NPPES record last updated: January 9, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 19, 2020, Jul 31, 2020 (2 updates tracked since 2020).

About Memorial Surgery Center Cedar Lake NPPES

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

MEMORIAL SURGERY CENTER CEDAR LAKE (NPI 1215546635) is a healthcare organization registered as a general acute care hospital in Biloxi, Mississippi and active in the NPI registry since July 2020. The organization holds a CLIA Waiver certificate valid through January 28, 2028 and lists Peggy Lorraine Noonan, Physician Business Services Dir., as its authorized official.

NPPES Registry Identity

NPI1215546635
Entity TypeOrganization
Primary Taxonomy282N00000X
Legal Business NameMEMORIAL HOSPITAL AT GULFPORT
Location Address1720B MEDICAL PARK DRBiloxi, MS 39532-2131
Mailing AddressPo Box 1810Gulfport, MS 39502-1810 · (228) 575-1342
Phone(228) 702-2000
Fax(228) 702-2018
Organization SubpartYes
Authorized OfficialPeggy Lorraine NoonanPhysician Business Services Dir. · (228) 575-1740
Enumeration DateJuly 31, 2020
Last NPPES UpdateJanuary 9, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2024
✔ NPI 1215546635 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.
1720B MEDICAL PARK DR, Biloxi, MS 39532
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Other Names 1

Doing Business AsMemorial Surgery Center Cedar Lake

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 Health and more.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 Surgery Center Cedar Lake 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 Surgery Center Cedar Lake, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 184 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
Angela Meadows, RN, MSN, FNP-BC
Nurse Practitioner
NPI 1679815609
1720A MEDICAL PARK DR STE 150
Biloxi, MS 39532
(228) 392-7429
✔ PECOS✔ Accepts MedicareSame address
Paul Mullen, M.D.
Cardiovascular Disease (Cardiology)
NPI 1114977451
1720A MEDICAL PARK DR SUITE 340
Biloxi, MS 39532
(228) 392-7429
✔ PECOS✔ Accepts MedicareSame address
Antoine Rizk, M.D.
Cardiovascular Disease (Cardiology)
NPI 1568411403
1720A MEDICAL PARK DR SUITE 340
Biloxi, MS 39532
(228) 392-7429
✔ PECOS✔ Accepts MedicareSame address
Musunkumuki Kadochi, MD
Pediatric Medicine
NPI 1275911810
1721 MEDICAL PARK DR STE 101
Biloxi, MS 39532
(601) 815-2005
✔ PECOS✔ Accepts Medicare0.1 mi
Rickey Chance, D.O.
Family Practice
NPI 1437264504
1759 MEDICAL PARK DR
Biloxi, MS 39532
(228) 385-0075
✔ PECOS✔ Accepts Medicare0.3 mi
Robyn Hudson, FNP
Nurse Practitioner
NPI 1528660552
971 TOMMY MUNRO DR STE C
Biloxi, MS 39532
(228) 392-7760
✔ PECOS✔ Accepts Medicare0.3 mi
Lauren Quave, FNP-BC
Nurse Practitioner
NPI 1881960136
1756 POPPS FERRY RD
Biloxi, MS 39532
(228) 865-3200
✔ PECOS✔ Accepts Medicare0.4 mi
Rebecca Rose, M.D.
Family Practice
NPI 1942439542
1756 POPPS FERRY RD
Biloxi, MS 39532
(228) 865-3200
✔ PECOS✔ Accepts Medicare0.4 mi
Jennifer Weber
Nurse Practitioner
NPI 1336281609
1756 POPPS FERRY RD STE A
Biloxi, MS 39532
(228) 865-3200
✔ PECOS0.4 mi
Tomika Dedeaux, FNP-C
Nurse Practitioner
NPI 1861957631
1990 POPPS FERRY RD
Biloxi, MS 39532
(228) 383-5119
✔ PECOS✔ Accepts Medicare1.3 mi
Vanessa Duncombe, M.D.
Family Practice
NPI 1881623650
3920 PROMENADE PKWY SUITE A
Diberville, MS 39540
(228) 456-0173
✔ PECOS✔ Accepts Medicare2.0 mi
Christopher Smelley, D.O.
Emergency Medicine
NPI 1134368939
400 VETERANS AVE
Biloxi, MS 39531
(228) 523-5000
✔ PECOS✔ Accepts Medicare2.4 mi
Christopher Fontimayor
Anesthesiology
NPI 1750618617
KEESLER AFB 301 FISHER STREET
Biloxi, MS 39534
(228) 382-8833
✔ PECOS✔ Accepts Medicare2.7 mi
Latoya Plummer, PT, DPT
Physical Therapist in Private Practice
NPI 1366886970
3179 MALLETT RD STE D
Diberville, MS 39540
(228) 392-4710
✔ Accepts Medicare2.8 mi
Matthew Hagen, DO
Hospitalist
NPI 1295231017
301 FISHER ST KEESLER AFB
Biloxi, MS 39534
(228) 376-0576
✔ PECOS✔ Accepts Medicare2.9 mi
Kyle Iverson
General Surgery
NPI 1639460397
301 FISHER ST
Biloxi, MS 39534
(228) 376-0425
✔ PECOS✔ Accepts Medicare2.9 mi
Wassem Juakiem, MD
Gastroenterology
NPI 1508177387
301 FISHER ST
Biloxi, MS 39534
(228) 376-2273
✔ PECOS✔ Accepts Medicare2.9 mi
Scott Sanders, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1063463420
301 FISHER ST
Biloxi, MS 39534
(228) 376-6013
✔ PECOS✔ Accepts Medicare2.9 mi
Nathan Sumner, M.D.
Neurology
NPI 1265652846
81MDOS/SGOMU 301 FISHER STREET STE 1F-130
Keesler Afb, MS 39534
(228) 376-3791
✔ PECOS✔ Accepts Medicare2.9 mi
Jared Bell, M.D.
Orthopedic Surgery
NPI 1467987545
301 FISHER ST
Keesler Afb, MS 39534
(904) 244-5946
✔ PECOS2.9 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 25D2003015

Memorial Surgery Center - Cedar Lake · Biloxi, MS
Active · expires Jan 28, 2028
CLIA Number25D2003015
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJanuary 29, 2026
Certificate Expiration DateJanuary 28, 2028
Laboratory DirectorAshley Ross
Laboratory Phone(228) 702-2000
Laboratory LocationMemorial Surgery Center - Cedar Lake1720B Medical Park Drive, Biloxi, MS 39532
CLIA data matches this NPI record on: Address 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 1215546635. It was assigned to this organization in the NPPES registry on July 31, 2020. The provider is doing business as Memorial Surgery Center Cedar Lake.

Where is Memorial Hospital At Gulfport located?

Memorial Hospital At Gulfport is located at 1720B Medical Park Dr, Biloxi, MS 39532. The listed phone number is (228) 702-2000.

What is Memorial Hospital At Gulfport's specialty?

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

Is Memorial Hospital At Gulfport enrolled in Medicare?

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

Does Memorial Hospital At Gulfport hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2003015) is associated with this NPI, valid through January 28, 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 1 other insurer 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.