MEMORIAL HOSPITAL AT GULFPORT
NPI 1619304185
Family Medicine in Gulfport, MS

Active since September 30, 2013
12261 HIGHWAY 49 STE 11, GULFPORT, MS 39503(228) 867-5185(228) 867-5189 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 1619304185) is a healthcare organization registered as a family medicine in Gulfport, Mississippi and active in the NPI registry since September 2013. The organization lists Peggy Lorraine Noonan, Physician Business Services Dir., as its authorized official.

NPPES Registry Identity

NPI1619304185
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMEMORIAL HOSPITAL AT GULFPORT
Location Address12261 HIGHWAY 49 STE 11Gulfport, MS 39503-2976
Mailing AddressPo Box 1810Gulfport, MS 39502-1810 · (228) 867-1700 · Fax (228) 575-1735
Fax(228) 867-5189
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 1619304185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedAllergy & ImmunologyTaxonomy 207K00000X
Also ListedInternal MedicineTaxonomy 207R00000X
12261 HIGHWAY 49 STE 11, Gulfport, MS 39503

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, 4 practice at this address and 339 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 1720368855
12261 HIGHWAY 49 SUITE 11
Gulfport, MS 39503
(228) 867-5185
✔ PECOSSame address
Nurse Practitioner
NPI 1326264953
12261 HIGHWAY 49 STE 11
Gulfport, MS 39503
(228) 867-5185
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1730268939
12261 HIGHWAY 49 SUITE 11
Gulfport, MS 39503
(228) 867-5185
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1295898724
12261 HIGHWAY 49 SUITE 11
Gulfport, MS 39503
(228) 575-2176
✔ PECOSSame address
Qualified Speech Language Pathologist
NPI 1508177726
12303 HIGHWAY 49
Gulfport, MS 39503
(228) 832-6221
0.1 mi
Internal Medicine
NPI 1104238153
12330 ASHLEY DR
Gulfport, MS 39503
(228) 831-1572
✔ PECOS✔ Accepts Medicare0.2 mi
Allergy/Immunology
NPI 1063527356
12100 HIGHWAY 49
Gulfport, MS 39503
(228) 867-5185
✔ PECOS✔ Accepts Medicare0.4 mi
Nurse Practitioner
NPI 1366774879
15476 DEDEAUX RD
Gulfport, MS 39503
(228) 230-2663
✔ PECOS✔ Accepts Medicare0.9 mi
Nurse Practitioner
NPI 1386772283
15444 DEDEAUX RD STE B
Gulfport, MS 39503
(228) 832-9038
✔ PECOS✔ Accepts Medicare1.0 mi
Nurse Practitioner
NPI 1124419031
11240 HIGHWAY 49 STE 300
Gulfport, MS 39503
(228) 284-4342
✔ PECOS✔ Accepts Medicare1.1 mi
Clinical Social Worker
NPI 1396883310
11150 HIGHWAY 49N
Gulfport, MS 39503
(228) 575-1000
✔ PECOS1.2 mi
Critical Care (Intensivists)
NPI 1730507096
15190 COMMUNITY RD STE 110
Gulfport, MS 39503
(228) 539-3356
✔ PECOS✔ Accepts Medicare1.5 mi
Anesthesiology
NPI 1073975017
15190 COMMUNITY RD
Gulfport, MS 39503
(228) 575-7290
✔ PECOS✔ Accepts Medicare1.5 mi
Pulmonary Disease
NPI 1972530335
15190 COMMUNITY RD SUITE 220
Gulfport, MS 39503
(228) 539-3356
✔ PECOS✔ Accepts Medicare1.5 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1578886669
15190 COMMUNITY RD STE 100
Gulfport, MS 39503
(985) 264-2375
✔ PECOS✔ Accepts Medicare1.5 mi
Obstetrics/Gynecology
NPI 1285122622
15190 COMMUNITY RD
Gulfport, MS 39503
(228) 539-7044
✔ PECOS✔ Accepts Medicare1.5 mi
Plastic and Reconstructive Surgery
NPI 1821485111
15190 COMMUNITY RD STE 240
Gulfport, MS 39503
(228) 202-2128
✔ PECOS✔ Accepts Medicare1.5 mi
Internal Medicine
NPI 1578591186
15286 COMMUNITY RD
Gulfport, MS 39503
(228) 832-5151
✔ PECOS✔ Accepts Medicare1.5 mi
Pediatric Medicine
NPI 1093819435
9454 THREE RIVERS RD SUITE A
Gulfport, MS 39503
(228) 864-7747
✔ PECOS2.8 mi
Cardiovascular Disease (Cardiology)
NPI 1922102219
14055 SEAWAY RD
Gulfport, MS 39503
(228) 868-5555
✔ PECOS✔ Accepts Medicare2.8 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 1619304185. 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 12261 Highway 49 Ste 11, Gulfport, MS 39503. The listed phone number is (228) 867-5185.

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, 4 practice at this address and 339 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.