Coastal Eye Surgery Center

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

012410 Issued in MS

Legal business name

COASTAL EYE SURGERY CENTER

Practice address

14245 Dedeaux Rd
Gulfport, MS 39503-3369

Phone

(228) 328-0972

NPI assigned

Oct 20, 2011

Last updated

Oct 20, 2011By 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

Donald W Benefield, MDNPI 1386636694

Title

President

Phone

(228) 328-0972

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Coastal Eye Surgery CenterCCN 25C0001082

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

• Donald W Benefield, MD

  • Specialist
  • Gulfport, MS
  • NPI 1386636694
  NPD (past) Authorized official

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1669757761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14245 DEDEAUX RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033369",
            "telephone_number": "228-328-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14245 DEDEAUX RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033369",
            "telephone_number": "228-328-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL EYE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "BENEFIELD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "228-328-0972",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "MS",
            "license": "012410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Clarity Collective LLC (Coastal Clarity Speech & Communication)
• Coastal Connections Pediatric Therapy LLC
• Coastal County Imaging Services, LLC
• Coastal Diagnostics PLLC (Coastal Laboratory Services)
• Coastal Ear, Nose and Throat, Head and Neck Surgery Associates, PLLC
• Coastal Family Health Center
• Coastal Family Health Center Inc
• Coastal Family Health Center Inc (Coastal Family Health Center Gulfport)
• Coastal Family Health Center Inc
• Coastal Family Health Center, Inc. (CFHC-Gulfport Health Center Extensioin)

• Ophthalmologic Surgery Clinic/Center in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Ophthalmologic Surgery Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.