Organization Active NPI

Family Medicine Specialist LLC

  • Legal Medicine
  • Fairhope, AL
National Provider Identifier
1043618226
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
6713 Issued in AL
Legal business name
FAMILY MEDICINE SPECIALIST LLC
Practice address
8367 Morphy Ave
Ste B
Fairhope, AL 36532-3653
Phone
(251) 410-6334
NPI assigned
Dec 19, 2014
Last updated
Dec 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Authorized official

Name
Dr. Michael L McBrearty, M DNPI 1689655052
Title
President
Phone
(251) 410-6334

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 6713 AL Primary

Addresses

Primary practice location

8367 Morphy Ave
Ste B
Fairhope, AL 36532-3653

Mailing address

8367 Morphy Ave
Ste B
Fairhope, AL 36532-3653
Phone (251) 410-6334

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150414002008 AL Part B Supplier - Clinic/Group Practice 3577881911 Receives reassigned benefits from 1 practitioner
Practice locations: Fairhope, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2090923Family Medicine Specialist8367 Morphy Ave Ste B, Fairhope, AL 36532Certificate of waiverFeb 2, 2027

National Provider Directory

National Provider Directory

Locations

8367 Morphy Ave
#B
Fairhope, AL 36532
Phone (251) 410-6334

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": "1418947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1043618226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8367 MORPHY AVE",
            "address_2": "STE B",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323653",
            "telephone_number": "251-410-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8367 MORPHY AVE",
            "address_2": "STE B",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323653",
            "telephone_number": "251-410-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-19",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "MCBREARTY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-410-6334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "AL",
            "license": "6713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.