Organization Active NPI

Coastal Wound Specialists LLC

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Gulfport, MS
National Provider Identifier
1336014612
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
Legal business name
COASTAL WOUND SPECIALISTS LLC
Practice address
4500 13TH St
Gulfport, MS 39501-2515
Phone
(228) 865-1330
Fax
(228) 865-1331
NPI assigned
Oct 7, 2025
Last updated
Oct 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Authorized official

Name
Brett Kathmann, MDNPI 1851666150
Title
Owner
Phone
(228) 865-1330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X NU Primary

Addresses

Primary practice location

4500 13TH St
Gulfport, MS 39501-2515

Mailing address

PO Box 6266
Gulfport, MS 39506-6266
Phone (228) 865-1330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260219001437 MS Part B Supplier - Clinic/Group Practice 0244710093 Receives reassigned benefits from 2 practitioners
Practice locations: Gulfport, MS; Bay St Louis, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1336014612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6266",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395066266",
            "telephone_number": "228-865-1330",
            "fax_number": "228-865-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-865-1330",
            "fax_number": "228-865-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL WOUND SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "KATHMANN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-865-1330",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.