Coast Hand Therapy, Inc.

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

OT0116 Issued in MS

Legal business name

COAST HAND THERAPY, INC.

Practice address

1105 39TH Ave
Gulfport, MS 39501-2654

Phone

(228) 575-4654

Fax

(228) 575-4651

NPI assigned

Jun 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Joseph Albert Church III, OTR/L-CHTNPI 1265470744

Title

Owner

Phone

(228) 575-4654

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Albert Church III, OTR/L-CHT

  • Hand Occupational Therapist
  • Gulfport, MS
  • NPI 1265470744

  Hand, MS

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1023055415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 39TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012654",
            "telephone_number": "228-575-4654",
            "fax_number": "228-575-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 39TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012654",
            "telephone_number": "228-575-4654",
            "fax_number": "228-575-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST HAND THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-575-4654",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "OTR/L-CHT"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "MS",
            "license": "OT0116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09382312",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Gulfport, MS
• Hand Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.