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DR. JESSE PULLEN PENICO MD
NPI 1912904590
Internal Medicine - Infectious Disease in Gulfport, MS

Active since June 28, 2005
1340 BROAD AVE, SUITE 300, GULFPORT, MS 39501(228) 575-2700(228) 575-2709 Get Directions Write a Review

NPPES record last updated: September 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jesse Pullen Penico Md NPPES

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

DR. JESSE PULLEN PENICO MD (NPI 1912904590) is an individual infectious disease provider in Gulfport, Mississippi, licensed in Mississippi (21358) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1912904590
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. JESSE PULLEN PENICOCredential: MD
Location Address1340 BROAD AVE, SUITE 300Gulfport, MS 39501-2404
Mailing AddressPo Box 1810Gulfport, MS 39502-1810 · (228) 575-2700 · Fax (228) 575-2710
Phone(228) 575-2700
Fax(228) 575-2709
Sole ProprietorNo
Enumeration DateJune 28, 2005
Last NPPES UpdateSeptember 22, 2020
NPPES CertifiedSeptember 22, 2020
✔ NPI 1912904590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Licenses✔ Licensed in MS · 21358✔ Licensed in FL · ME72349✔ Licensed in LA · 015311
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
1340 BROAD AVE, Gulfport, MS 39501
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Other Identifiers 2

Medicaid1339181LA
Medicaid00112089MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Other Providers at the Same Location NPPES 20

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

DR. NABIL AZAR M.D.
Hospitalist
1340 BROAD AVE, SUITE 310
GULFPORT, MS 39501
Harrison County (228) 575-1400
DR. PAUL DEREK WARE MD
Surgery
1340 BROAD AVE, SUITE 240
GULFPORT, MS 39501
Harrison County (228) 575-1200
GULF COAST SPINAL & NEUROSURGICAL SPECIALISTS
Clinic/Center (Ambulatory Surgical)
1340 BROAD AVE, SUITE 440
GULFPORT, MS 39501
Harrison County (228) 822-2117
MEMORIAL HOSPITAL AT GULFPORT
Radiology (Radiation Oncology)
1340 BROAD AVE, SUITE 140
GULFPORT, MS 39501
Harrison County (228) 818-0563
CHRISTY M COUEVAS
Nurse Anesthetist, Certified Registered
1340 BROAD AVE
GULFPORT, MS 39501
Harrison County (228) 575-2902
CRAIG A DAWKINS M.D.
Urology
1340 BROAD AVE, SUITE 210
GULFPORT, MS 39501
Harrison County (228) 863-4490
MEMORIAL HOSPITAL AT GULFPORT
Internal Medicine (Gastroenterology)
1340 BROAD AVE, SUITE 300
GULFPORT, MS 39501
Harrison County (228) 575-1200
WALTER JOSPEH SUROWIEC JR. D.O.,F.A.C.S.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1340 BROAD AVE, STE 420
GULFPORT, MS 39501
Harrison County (228) 575-1500

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 Jesse Penico's NPI number?

The NPI number for Jesse Penico is 1912904590. It was assigned to this individual provider in the NPPES registry on June 28, 2005.

Where is Jesse Penico located?

Jesse Penico practices at 1340 Broad Ave Suite 300, Gulfport, MS 39501. The listed phone number is (228) 575-2700.

What is Jesse Penico's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

What insurance does Jesse Penico accept?

Health plans from Molina Healthcare list Jesse Penico 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 Jesse Penico was last updated on September 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.