Organization Active NPI

Gulf Coast Occupational Sports and Pain Medicine LLC

  • Family Medicine Physician
  • Foley, AL
National Provider Identifier
1003238569
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23039 Issued in AL
Legal business name
GULF COAST OCCUPATIONAL SPORTS AND PAIN MEDICINE LLC
Practice address
1400 N McKenzie St
Foley, AL 36535-2234
Phone
(251) 923-2050
Fax
(251) 923-2051
NPI assigned
Jan 16, 2014
Last updated
Dec 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Authorized official

Name
Ron R Lee, M.D.
Title
Owner
Phone
(251) 923-2050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 23039 AL Primary

Addresses

Primary practice location

1400 N McKenzie St
Foley, AL 36535-2234

Mailing address

1400 N McKenzie St
Foley, AL 36535-2234
Phone (251) 923-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140825002687 AL Part B Supplier - Clinic/Group Practice 6406074905 Receives reassigned benefits from 1 practitioner
Practice locations: Foley, AL

National Provider Directory

National Provider Directory

Locations

222 S Alston St
Foley, AL 36535
Phone (850) 633-4877

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1003238569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352234",
            "telephone_number": "251-923-2050",
            "fax_number": "251-923-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352234",
            "telephone_number": "251-923-2050",
            "fax_number": "251-923-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST OCCUPATIONAL SPORTS AND PAIN MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "RON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-923-2050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "23039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.