Coastal Chronic Pain Services, PLLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

COASTAL CHRONIC PAIN SERVICES, PLLC

Practice address

15190 Community Rd Ste 230B
Gulfport, MS 39503-3483

Phone

(228) 831-0050

Fax

(228) 831-1121

NPI assigned

Oct 4, 2006

Last updated

Nov 9, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

GULFPORT ANESTHESIA SERVICES, P.A.As reported in NPPES

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

Authorized official

Name

Diane Schultz

Title

Director

Phone

(228) 831-0204

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Gulfport Anesthesia Ser

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Gulfport Anesthesia Services, P.a.

  • Specialist
  • Gulfport, MS
  • NPI 1821033796
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian R Dix, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Gulfport, MS
  • NPI 1932215464
  Medicare reassignment NPD
• Charles M. Lobrano, M.D.

  • Anesthesiology Physician
  • Gulfport, MS
  • NPI 1386759835
  Medicare reassignment NPD
• Kent T Overmyer, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Gulfport, MS
  • NPI 1821104365
  Medicare reassignment NPD
• Carl A Mayeaux, MD

  • Anesthesiology Physician
  • New Orleans, LA
  • NPI 1578514238
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541721600000",
    "number": "1134214331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD STE 230B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033483",
            "telephone_number": "228-831-0050",
            "fax_number": "228-831-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD STE 230B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033483",
            "telephone_number": "228-831-0050",
            "fax_number": "228-831-1121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3017 13th St",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395011833",
            "country_code": "US",
            "telephone_number": "228-831-9343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL CHRONIC PAIN SERVICES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GULFPORT ANESTHESIA SERVICES, P.A.",
        "enumeration_date": "2006-10-04",
        "last_updated": "2018-11-09",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "228-831-0204"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Pain Medicine (Anesthesiology) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.