Coastal Rehabilitation of South Mississippi

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

COASTAL REHABILITATION OF SOUTH MISSISSIPPI

Practice address

15190 Community Rd
Suite 110
Gulfport, MS 39503-3485

Phone

(228) 831-4646

NPI assigned

Aug 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joe Frame, PT

Title

Owner

Phone

(228) 831-4646

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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.

• Ira Eugene Gaddy III, MD

  • Ophthalmology Physician
  • Gulfport, MS
  • NPI 1730298506
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376651299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD",
            "address_2": "SUITE 110",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033485",
            "telephone_number": "228-831-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD",
            "address_2": "SUITE 110",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033485",
            "telephone_number": "228-831-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL REHABILITATION OF SOUTH MISSISSIPPI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRAME",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-831-4646",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08220738",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6408090089",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Coastal Medical Supply LLC
• Coastal Pediatric Dentistry, LLC
• Coastal Plains Home Health Agency 9a
• Coastal Ultrasound, Inc.
• Coastal Wound Specialists LLC
• Coastkids Pediatric Dentistry, PLLC
• Coastline Health & Wellness, LLC
• Alexandria Cobb

• Physical Therapist in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.