ALABAMA PROVIDENCE HEALTHCARE SERVICES (NPI# 1316464183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316464183 |
| Entity Type | Organization |
| Organization Name | ALABAMA PROVIDENCE HEALTHCARE SERVICES |
| Other Organization Name | PROVIDENCE MEDICAL GROUP - FAIRHOPE |
| Practice Address |
411 N Section St Fairhope AL 36532-2649 |
| Mailing Address |
Po Box 850489 Mobile AL 36685-0489 |
| Practice Telephone | 2513423949 |
| Mailing Telephone | 2513423949 |
| Mailing Fax Number | 2516313361 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |
| Authorized Official Name | TODD KENNEDY (PRESIDENT) |
| Authorized Official Telephone | 2516331000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Medical Group - Fairhope | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093241671 | Alabama Providence Healthcare Services | Otolaryngology | 6701 Airport Blvd, Suite B123, Mobile, AL 36608-6705 | 2017-05-03 |
| 1730613431 | Alabama Providence Healthcare Services | Pediatrics | 6908 Providence Park Dr S, Mobile, AL 36695-4600 | 2017-04-19 |
| 1447799861 | Alabama Providence Healthcare Services | Family Medicine | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2017-02-17 |
| 1629511753 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Ste B215, Mobile, AL 36608-6705 | 2016-11-21 |
| 1891245692 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite D143, Mobile, AL 36608-6705 | 2016-10-05 |
| 1649634395 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite A-t06, Mobile, AL 36608-6705 | 2016-04-08 |
| 1558725200 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite B329, Mobile, AL 36608-6705 | 2016-04-08 |
| 1851755581 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite B222, Mobile, AL 36608-6705 | 2016-04-08 |
| 1689038382 | Alabama Providence Healthcare Services | Specialist | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2016-04-08 |
| 1639533383 | Alabama Providence Healthcare Services | Hospitalist | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2016-04-08 |
| Street Address |
411 N SECTION ST |
| City | FAIRHOPE |
| State | AL |
| Zip Code | 36532-2649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548262108 | Jeffrey Leigh Wallace | Preventive Medicine | 411 N Section St, Fairhope, AL 36532-2649 | 2005-08-12 |
| 1932547437 | Southern Eye Group of Alabama, LLC | Ophthalmology | 411 N Section St, Fairhope, AL 36532-2649 | 2013-06-06 |
| 1699068783 | Eastern Shore Care Services | Clinic/Center | 411 N Section St, Fairhope, AL 36532-2649 | 2011-05-23 |
| 1104011964 | Clearlyusa.com, L.L.C. | Audiologist-Hearing Aid Fitter | 411 N Section St, Fairhope, AL 36532-2649 | 2007-09-13 |
| 1164614137 | Eastern Shore Care Services, P.C. | Surgery | 411 N Section St, Fairhope, AL 36532-2649 | 2007-08-14 |
| 1114046026 | Bay Eyes Spectacular, Inc | Technician/Technologist | 411 N Section St, Fairhope, AL 36532-2649 | 2007-03-29 |
| 1700801370 | Mary E Johnsten | Physician Assistant | 411 N Section St, Fairhope, AL 36532 | 2006-07-13 |
| 1518919406 | Julia Centanni Ellison | Family Medicine | 411 N Section St, Fairhope, AL 36532-2649 | 2006-05-17 |
| 1649222670 | Kathryn M. Slaughter | Nurse Anesthetist, Certified Registered | 411 N Section St, Fairhope, AL 36532-2649 | 2006-05-17 |
| 1386615961 | James Daniel Wilder IIi | Optometrist | 411 N Section St, Fairhope, AL 36532-2634 | 2006-01-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000729 | Abby Stockman | Marriage & Family Therapist | 372 S. Greeno Road, Fairhope, AL 36532 | 2019-02-21 |
| 1962973990 | Pain Consultants of Alabama | Non-Pharmacy Dispensing Site | 320 North Greeno Rd., Fairhope, AL 36532 | 2018-12-17 |
| 1881182236 | Interface Medical Consulting LLC | Family Medicine | 12141 Cri, Fairhope, AL 36532 | 2018-05-01 |
| 1063937167 | Julia W Stone, LLC | Counselor | 21180 Al State Hwy 181, Suite 2, Fairhope, AL 36532 | 2017-08-09 |
| 1568985349 | Eastern Shore Oral, Facial and Implant Surgery Center, P.C. | Clinic/Center | 24172 4th Street, Fairhope, AL 36532 | 2017-07-24 |
| 1205209509 | Comfort Care Coastal Hospice, LLC | Hospice Care, Community Based | 22502 U.S. Highway 98, Fairhope, AL 36532 | 2015-11-09 |
| 1609248632 | Sabrina Reeves | Physician Assistant | 77 Magnolia Ave, Fairhope, AL 36532 | 2015-10-29 |
| 1386025146 | Laura Lasecki Wimmer | Podiatrist | 23937 Us Highway 98 Ste 1, Fairhope, AL 36532 | 2015-06-17 |
| 1386024719 | Gulf Coast Homecare LLC Dba Firstlight Homecare of Mobile Eastern Shor | In Home Supportive Care | 924 Plantation Blvd., Suite C, Fairhope, AL 36532 | 2015-06-01 |
| 1386021525 | June Lassiter | Nurse Practitioner | 22823 Ecor Rouge Lane, Fairhope, AL 36532 | 2015-04-27 |
| Find all providers in zip 36532 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881182236 | Interface Medical Consulting LLC | Family Medicine | 12141 Cri, Fairhope, AL 36532 | 2018-05-01 |
| 1124425061 | Infiniti Health LLC | Family Medicine | 306 Saint Charles Ct, Fairhope, AL 36532-4221 | 2014-11-20 |
| 1679869127 | Alexander James Minney | Family Medicine | 300 Greeno Rd S Ste B, Fairhope, AL 36532 | 2011-06-23 |
| 1851685150 | Vaughn H. Mancha, Jr., P.C. | Family Medicine | 17328 Burwick Loop, Fairhope, AL 36532-5243 | 2011-06-03 |
| 1467751602 | Sean R Mcbrearty | Family Medicine | 8367 Morphy Ave Ste B, Fairhope, AL 36532-3653 | 2011-03-25 |
| 1689770935 | Robert Ewing Mcalister Jr. | Family Medicine | 23710 Us Highway 98, Suite B, Fairhope, AL 36532-6350 | 2006-09-15 |
| 1184738668 | Vaughn H Mancha Jr. | Family Medicine | 17326 Burwick Loop, Fairhope, AL 36532 | 2006-08-19 |
| 1053355743 | Kristin B Kalmbacher | Family Medicine | 100 N Bancroft St, Suite A2, Fairhope, AL 36532-2444 | 2006-06-15 |
| 1427015247 | Karl Stanley Self | Family Medicine | 306 S Greeno Rd, Suite A, Fairhope, AL 36532-1905 | 2006-04-26 |
| 1851370266 | Regan M Andrade | Family Medicine | 21875 State Highway 181, Fairhope, AL 36532-4481 | 2006-01-13 |
| Find all providers in FAIRHOPE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.