NPIMap

Organization Active NPI

Urgent Care 59, PC

  • Rural Health Clinic/Center
  • Bay Minette, AL
National Provider Identifier
1093415671
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
URGENT CARE 59, PC
Practice address
108C McMeans Ave
Bay Minette, AL 36507-3130
Phone
(251) 491-0059
Fax
(251) 571-4002
NPI assigned
Mar 3, 2023
Last updated
Mar 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Authorized official

Name
Bridgot Peters
Title
Billing Director
Phone
(251) 445-7618

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Urgent Care Clinic/Center 261QU0200X NU
General Practice Physician 208D00000X NU

Addresses

Primary practice location

108C McMeans Ave
Bay Minette, AL 36507-3130

Mailing address

108C McMeans Ave
Bay Minette, AL 36507-3130
Phone (251) 491-0059

Other identifiers 1

IdentifierTypeStateIssuer
308268MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230623002674 AL Part B Supplier - Clinic/Group Practice 6002274925 Receives reassigned benefits from 17 practitioners
Practice locations: Bay Minette, AL
O20240829000607 AL Part A Provider - Rural Health Clinic 6002274925 Practice locations: Bay Minette, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093415671. Details of each certification follow.

Rural health clinic certification: CCN 018983

Legal name
URGENT CARE 59 PC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 5, 2025
Last certification
Mar 5, 2025
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Feb 22, 2023 in AL
Enrollment address
108C McMeans Ave
Bay Minette, AL 36507-3130

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lauren Day Individual 5% Or Greater Direct Ownership InterestPartner Feb 22, 2023 20%
Corporate OfficerPartner Feb 22, 2023
W-2 Managing EmployeePresident Feb 22, 2023
Geoffrey L Odom Individual 5% Or Greater Direct Ownership InterestPartner Feb 22, 2023 20%
Corporate OfficerPartner Feb 22, 2023
Jeffrey a Whitener Individual 5% Or Greater Direct Ownership InterestPartner Feb 22, 2023 20%
Corporate DirectorMedical Director Feb 22, 2023
W-2 Managing EmployeeMD; Feb 22, 2023
Robert E Vickers Individual 5% Or Greater Direct Ownership InterestPartner Feb 22, 2023 20%
Corporate OfficerPartner Feb 22, 2023
Jennifer Bethea Individual W-2 Managing EmployeePractice Administrator Mar 1, 2023
Operational/Managerial ControlPractice Administrator Mar 1, 2023
Darren Waters Individual 5% Or Greater Direct Ownership InterestPartner Feb 22, 2023 20%
Corporate OfficerPartner Feb 22, 2023

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1093415671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108C MCMEANS AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365073130",
            "telephone_number": "251-491-0059",
            "fax_number": "251-571-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108C MCMEANS AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365073130",
            "telephone_number": "251-491-0059",
            "fax_number": "251-571-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE 59, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-03",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "BRIDGOT",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "251-445-7618"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308268",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Minette, AL

Sources for this page

Verify at the official NPI Registry.