MEDICARE: COASTAL CONNECTIONS PEDIATRIC THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1407701956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL CONNECTIONS PEDIATRIC THERAPY LLC

Provider Business Mailing Address
First Line	:	10331 PATRICK DR
Second Line	:
City	:	GULFPORT
State	:	MS
Zip	:	39503-4093
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10331 PATRICK DR
Second Line	:
City	:	GULFPORT
State	:	MS
Zip	:	39503-4093
Country	:	US
Telephone Number	:	228-574-5225
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	KAYLA RIGSBY
Credential	:	OTR/L
Telephone Number	:	228-574-5225

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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