Organization Active NPI

Eastern Shore Care Services, P.C.

  • Plastic and Reconstructive Surgery Physician
  • Fairhope, AL
National Provider Identifier
1164614137
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
EASTERN SHORE CARE SERVICES, P.C.
Practice address
411 N Section St
Fairhope, AL 36532-2649
Phone
(251) 591-3978
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Valerie Ann Larson-Lohr
Title
Business Manager
Phone
(210) 494-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

411 N Section St
Fairhope, AL 36532-2649

Mailing address

2935 Thousand Oaks Dr Ste 294
San Antonio, TX 78247-3563
Phone (210) 494-1100

Other names 1

  • Eastern Shore Aesthetic Services PC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051118000710 AL Part B Supplier - Clinic/Group Practice 3072532076 Receives reassigned benefits from 1 practitioner
Practice locations: Fairhope, AL

National Provider Directory

National Provider Directory

Locations

411 N Section St
Ste 101
Fairhope, AL 36532
Phone (251) 928-9090

188 Hospital Dr
Ste 203
Fairhope, AL 36532
Phone (251) 990-1990

5992 Berryhill Rd
Ste 200
Milton, FL 32570
Phone (850) 474-8000

13467 Wetmore Rd
Wetmore, TX 78247

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1164614137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 THOUSAND OAKS DR STE 294",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782473563",
            "telephone_number": "210-494-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N SECTION ST",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322649",
            "telephone_number": "251-591-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE CARE SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "LARSON-LOHR",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "210-494-1100"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Shore Aesthetic Services PC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Eastern Shore Aesthetic Services PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 17, 2025; 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.