Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Christopher Shane Blomberg, MD, MS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1982023149

Christopher Shane Blomberg, MD, MS is a Family Practice in Lucedale, Mississippi. Graduated from Louisiana State University School of Medicine in Shreveport in 2017, 9 years ago. Practices with Memorial Hospital at Gulfport, a 470-clinician group, works from 3 locations and offers telehealth. Licensed in Mississippi.

Years since qualifying
9
Trained at
Louisiana State University School of Medicine in Shreveport
Licensed in
MS
In the registry since
2014
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MS — Master of Science
A graduate science degree.

See every abbreviation used in this directory →

Practice location Address checks out

859 Winter St
Lucedale, MS 39452-6603
Phone: (601) 947-3161
Fax: (601) 947-1331
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4864 Jackson St, Monroe, LA 71202-6400 — (318) 330-7650
  • 92 Ratliff St, Lucedale, MS 39452-6537 — (601) 947-8181

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 25078 (MS)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1982023149
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MS
Sole proprietorNo
NPI enumeratedApril 15, 2014
Last updated in NPPESJuly 21, 2022
Mailing address4864 Jackson St, Family Medicine, Monroe, LA 71202-6400

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated 2017 (9 years in practice)
Group practice Memorial Hospital At Gulfport — 470 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Lucedale