NPIMap

Organization Active NPI

Gulf Coast Wound Associates LLC

  • Wound Care Registered Nurse
  • Diamondhead, MS
National Provider Identifier
1467118448
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
Legal business name
GULF COAST WOUND ASSOCIATES LLC
Practice address
5427 Gex Rd
Diamondhead, MS 39525-3208
Phone
(228) 255-4832
NPI assigned
Nov 13, 2021
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Dr. Nathan Gill, DONPI 1194920389
Title
Physician
Phone
(228) 236-4066

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
Wound Care Registered Nurse 163WW0000X Primary

Addresses

Primary practice location

5427 Gex Rd
Diamondhead, MS 39525-3208

Mailing address

PO Box 6705
Gulfport, MS 39506-6705
Phone (228) 865-1330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220323002319 MS Part B Supplier - Clinic/Group Practice 2466847744 Receives reassigned benefits from 15 practitioners
Practice locations: Gulfport, MS; Ocean Springs, MS; Pascagoula, MS; Pass Christian, MS; Picayune, MS; Wiggins, MS; Bay St Louis, MS; Biloxi, MS…

National Provider Directory

National Provider Directory

Locations

12261 Highway 49
Ste 14
Gulfport, MS 39503
Phone (226) 678-1751

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1636761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1467118448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6705",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395066705",
            "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": "5427 GEX RD",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253208",
            "telephone_number": "228-255-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST WOUND ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-13",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "228-236-4066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamondhead, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.