MEMORIAL HOSPITAL AT GULFPORT
NPI 1346677812
Family Medicine in Diamondhead, MS

Active since September 30, 2013
4300 LEISURE TIME DR, SUITE A, DIAMONDHEAD, MS 39525(228) 255-4300(228) 255-3626 Get Directions Write a Review

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

About Memorial Hospital At Gulfport NPPES

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

MEMORIAL HOSPITAL AT GULFPORT (NPI 1346677812) is a healthcare organization registered as a family medicine in Diamondhead, Mississippi and active in the NPI registry since September 2013. The organization maintains a secondary practice location in Diamondhead and lists Peggy Lorraine Noonan, Physician Business Services Dir., as its authorized official.

NPPES Registry Identity

NPI1346677812
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMEMORIAL HOSPITAL AT GULFPORT
Location Address4300 LEISURE TIME DR, SUITE ADiamondhead, MS 39525-3241
Mailing AddressPo Box 1810Gulfport, MS 39502-1810 · (228) 575-1700 · Fax (228) 575-1735
Fax(228) 255-3626
Organization SubpartNo
Authorized OfficialPeggy Lorraine NoonanPhysician Business Services Dir. · (228) 575-1740
Enumeration DateSeptember 30, 2013
Last NPPES UpdateJanuary 9, 2024
NPPES CertifiedJanuary 9, 2024
✔ NPI 1346677812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ 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.
Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X
Also ListedNeurological SurgeryTaxonomy 207T00000X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
4300 LEISURE TIME DR, Diamondhead, MS 39525

Secondary Practice Location 1

Location 145000 E Aloha DrDiamondhead, MS 39525-3373 · Phone (228) 822-6006

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 Hospital At Gulfport 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 Hospital At Gulfport, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 29 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 1649341256
4300 LEISURE TIME DR
Diamondhead, MS 39525
(228) 255-4300
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1932118965
4300 LEISURE TIME DR
Diamondhead, MS 39525
(228) 255-4300
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1952961500
45000 E ALOHA DRIVE
Diamondhead, MS 39525
(228) 822-6066
✔ PECOS✔ Accepts Medicare0.2 mi
Family Practice
NPI 1568423697
4433 LEISURE TIME DR.
Diamondhead, MS 39525
(228) 586-9229
✔ PECOS✔ Accepts Medicare0.2 mi
Family Practice
NPI 1679543102
4433 LEISURE TIME
Diamondhead, MS 39525
(228) 586-9229
✔ PECOS0.2 mi
Nurse Practitioner
NPI 1265799977
4433 LEISURE TIME DR
Diamondhead, MS 39525
(228) 586-9229
✔ PECOS0.2 mi
Family Practice
NPI 1427673532
45000 E ALOHA DR. STE A
Diamondhead, MS 39525
(228) 822-6006
✔ PECOS✔ Accepts Medicare0.3 mi
Nurse Practitioner
NPI 1184894354
4540 B SHEPHERDS SQUARD
Diamondhead, MS 39525
(228) 255-8216
✔ PECOS✔ Accepts Medicare0.3 mi
Anesthesiology
NPI 1841238557
952 KALIKIMAKA PL
Diamondhead, MS 39525
(228) 586-1450
✔ PECOS✔ Accepts Medicare1.8 mi
Nurse Practitioner
NPI 1841642733
952 GREEN MEADOW RD
Bay Saint Louis, MS 39520
(228) 463-1649
✔ PECOS✔ Accepts Medicare4.2 mi
Internal Medicine
NPI 1053369801
952 GREEN MEADOW RD
Bay St Louis, MS 39520
(228) 463-1649
✔ PECOS✔ Accepts Medicare4.2 mi
Nurse Practitioner
NPI 1962854885
952 GREEN MEADOW RD
Bay St Louis, MS 39520
(228) 463-1649
✔ PECOS✔ Accepts Medicare4.2 mi
Nurse Practitioner
NPI 1629300231
149 DRINKWATER BLVD
Bay Saint Louis, MS 39520
(228) 395-1255
✔ PECOS4.3 mi
Family Practice
NPI 1609076124
149 DRINKWATER RD
Bay St Louis, MS 39520
(228) 220-5200
✔ PECOS✔ Accepts Medicare4.4 mi
Internal Medicine
NPI 1780687855
1001 BENIGNO LANE
Bay St Louis, MS 39520
(228) 467-1414
✔ PECOS✔ Accepts Medicare4.4 mi
Obstetrics/Gynecology
NPI 1811061831
1009 BENIGNO LANE
Bay Saint Louis, MS 39520
(228) 467-2555
✔ PECOS✔ Accepts Medicare4.4 mi
General Surgery
NPI 1619976636
202C DRINKWATER RD
Bay St Louis, MS 39520
(228) 463-8939
✔ PECOS✔ Accepts Medicare4.4 mi
Family Practice
NPI 1316567415
835 THAMES AVE
Bay St Louis, MS 39520
(228) 575-2383
✔ PECOS✔ Accepts Medicare4.4 mi
Pediatric Medicine
NPI 1942241922
833 HIGHWAY 90
Bay St Louis, MS 39520
(228) 396-3141
✔ PECOS4.5 mi
General Surgery
NPI 1356349401
833 HIGHWAY 90 STE 1
Bay St Louis, MS 39520
(228) 575-2920
✔ PECOS✔ Accepts Medicare4.5 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.

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 1346677812. It was assigned to this organization in the NPPES registry on September 30, 2013.

Where is Memorial Hospital At Gulfport located?

Memorial Hospital At Gulfport is located at 4300 Leisure Time Dr Suite A, Diamondhead, MS 39525. The listed phone number is (228) 255-4300.

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, 2 practice at this address and 29 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.