Bayou la Batre Area Health Development Board, Inc.
Organization Active NPI Clinic/Center · McIntosh, AL
NPI 1023068459 · NPPES record last updated Apr 25, 2013
Key facts
- NPI
- 1023068459
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- PHL L6503 (AL)
- Legal business name
- BAYOU LA BATRE AREA HEALTH DEVELOPMENT BOARD, INC.
- Practice address
- 7777 Highway 43 North
McIntosh, AL 36553-0415 - Phone
- (251) 944-2842
- Fax
- (251) 944-8070
- NPI assigned
- May 10, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- BAYOU LA BATRE AREA HEALTH DEVELOPMENT BOARD, INC.
Authorized official
- Name
- Mr. James A. Holland, MPH
- Title
- Chief Executive Officer
- Phone
- (251) 824-2174
Practitioners 24
-
Ashly M. Acosta, CRNP
-
Lilly Deonna Adkison, FNP
-
Kosi James Avotri, M.D.
-
Carla Ann Baxley, CRNP
-
Allison Casey Calhoun, M.D.
-
James Raymond Chinners, LICSW
-
Huguette Douyon, D.O.
-
Sonia Singh Grevenitis, M.D.
-
Aayushka Gurung, MD
-
Amelia Ruth Hewes, M.D.
-
Nicolette Holliday, M.D.
-
Eliceia Dionne Jackson, M.D.
-
Richard C Layzod, LICSW
-
Ashley McBride, CRNP
-
James Denis Menard, O.D.
-
Tracy Young Roth, M.D.
-
Alan Jay Sherman, MD
-
Craig D. Sherman, MD
-
Monica Clark Taylor, C.R.N.P.
-
Phillip Turner, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D0692409 | Southwest Alabama Health Services | Compliance | Dec 10, 2027 |
National Provider Directory
- Part of
- Midtown Mostellar Med CLN
Locations
12701 Padgett Switch Rd
Bldg 1
Irvington, AL 36544
7777 Highway 43
Mc Intosh, AL 36553
Phone (251) 944-2842
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CIEDDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | PHL L6503 | AL | Yes |
Addresses
Primary practice location
7777 Highway 43 North
McIntosh, AL 36553-0415
Mailing address
P.O. Box 415
7777 Hwy 43 North
MC Intosh, AL 36553-0415
Phone (251) 944-2842
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 630002015 | Medicaid | AL | |
| 01DO692409 | Other | AL | CLIA |
| 630000015 | Medicaid | AL |
Other names
- Southwest Alabama Health Services
Other providers in McIntosh, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.