Gulf Coast Ear Nose and Throat Associates, LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

GULF COAST EAR NOSE AND THROAT ASSOCIATES, LLC

Practice address

9000 Lorraine Rd
Gulfport, MS 39503-6101

Phone

(228) 864-2121

Fax

(228) 678-0950

NPI assigned

Jun 8, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Bryan D Leatherman, MDNPI 1154367738

Title

Owner

Phone

(228) 864-2121

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 3

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

• Bryan David Leatherman, M.D.

  • Otolaryngic Allergy Physician
  • Gulfport, MS
  • NPI 1154367738

  Otolaryngology

  Medicare reassignment NPD Authorized official
• Jacinta Stegall

  • Nurse Practitioner
  • Tupelo, MS
  • NPI 1699127027
  Medicare reassignment NPD
• Karen Keel Williams

  • Audiologist
  • Gulfport, MS
  • NPI 1780945402
  Medicare reassignment NPD

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1689241622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 LORRAINE RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395036101",
            "telephone_number": "228-864-2121",
            "fax_number": "228-678-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 LORRAINE RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395036101",
            "telephone_number": "228-864-2121",
            "fax_number": "228-678-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST EAR NOSE AND THROAT ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "LEATHERMAN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-864-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Brain & Spine Institute
• Gulf Coast Companion Care, LLC
• Gulf Coast Dental Care, PLLC
• Gulf Coast Dental Center
• Gulf Coast Dermatology, PA
• Gulf Coast Endocrinology
• Gulf Coast Endodontic Associates, LLC
• Gulf Coast Imaging
• Gulf Coast Interventional Pain Management Clinic, Inc
• Gulf Coast Interventional Pain Management Clinic, Inc.

• Otolaryngology Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Otolaryngology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.