One Source of the Gulf Coast Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ONE SOURCE OF THE GULF COAST INC.

Practice address

1903 Spring Hill Ave
Mobile, AL 36607-2303

Phone

(251) 459-8600

Fax

(251) 459-8601

NPI assigned

Aug 15, 2017

Organization subpart

No

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

Authorized official

Name

William K. WadeNPI 1902393614

Title

V.P.

Phone

(228) 875-3828

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• William K Wade, BOCP, COF, C.PED.

  • Prosthetist
  • Ocean Springs, MS
  • NPI 1902393614

  Orthotist

  NPD Authorized official
• Jay Michael Rubenstein, BOCP

  • Prosthetist
  • Ocean Springs, MS
  • NPI 1285247783
  NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1487170197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 BIENVILLE BLVD STE 1",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644370",
            "telephone_number": "228-875-3828",
            "fax_number": "228-436-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072303",
            "telephone_number": "251-459-8600",
            "fax_number": "251-459-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE SOURCE OF THE GULF COAST INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-15",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "V.P.",
        "authorized_official_telephone_number": "228-875-3828"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Mobile, AL
• Providers in Mobile, AL by specialty
• Prosthetic/Orthotic Supplier in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.