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GULF COAST RECOVERY CLINIC
NPI 1922888148
Clinic/Center - Rehabilitation, Substance Use Disorder in Gulfport, MS

Active since October 04, 2023
14231 SEAWAY RD STE 2003, GULFPORT, MS 39503(228) 594-3377(228) 594-6688 Get Directions Write a Review

NPPES record last updated: October 4, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Gulf Coast Recovery Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GULF COAST RECOVERY CLINIC (NPI 1922888148) is a healthcare organization registered as a rehabilitation, substance use disorder in Gulfport, Mississippi and active in the NPI registry since October 2023. The organization lists Betty Matthews, Manager, as its authorized official.

NPPES Registry Identity

NPI1922888148
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameGULF COAST RECOVERY CLINIC
Location Address14231 SEAWAY RD STE 2003Gulfport, MS 39503-4635
Mailing Address14231 Seaway Rd Ste 2003Gulfport, MS 39503-4635 · (228) 594-3377
Phone(228) 594-3377
Fax(228) 594-6688
Organization SubpartNo
Authorized OfficialBetty MatthewsManager · (228) 594-3377
Enumeration DateOctober 4, 2023
NPPES CertifiedOctober 4, 2023
✔ NPI 1922888148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
14231 SEAWAY RD STE 2003, Gulfport, MS 39503
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gulf Coast Recovery Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Gulf Coast Recovery Clinic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Avery Jackson, APRN, FNP-C
Nurse Practitioner
NPI 1548798218
14231 SEAWAY RD STE 2003
Gulfport, MS 39503
(228) 594-3377
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gulf Coast Recovery Clinic's NPI number?

The NPI number for Gulf Coast Recovery Clinic is 1922888148. It was assigned to this organization in the NPPES registry on October 4, 2023.

Where is Gulf Coast Recovery Clinic located?

Gulf Coast Recovery Clinic is located at 14231 Seaway Rd Ste 2003, Gulfport, MS 39503. The listed phone number is (228) 594-3377.

What is Gulf Coast Recovery Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Is Gulf Coast Recovery Clinic enrolled in Medicare?

Yes. Gulf Coast Recovery Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gulf Coast Recovery Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Gulf Coast Recovery Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Gulf Coast Recovery Clinic was last updated on October 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.