NPIMap

Organization Active NPI

Bayside Orthopedic & Rehabilitation Center PC

  • Orthopaedic Surgery Physician
  • Foley, AL
National Provider Identifier
1174804686
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BAYSIDE ORTHOPEDIC & REHABILITATION CENTER PC
Practice address
1622 N McKenzie St
Foley, AL 36535-2248
Phone
(251) 928-2401
Fax
(251) 928-5099
NPI assigned
Aug 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Authorized official

Name
Rachel L Ellis
Title
Office Manager
Phone
(251) 928-2401

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X

Addresses

Primary practice location

1622 N McKenzie St
Foley, AL 36535-2248

Mailing address

PO Box 1186
Fairhope, AL 36533-1186
Phone (251) 928-2401

Other identifiers 1

IdentifierTypeStateIssuer
528700580MedicaidAL

Other names 1

  • Bayside Orthopaedic, Sports Medicine & Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555977600000",
    "number": "1174804686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1186",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365331186",
            "telephone_number": "251-928-2401",
            "fax_number": "251-928-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352248",
            "telephone_number": "251-928-2401",
            "fax_number": "251-928-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE ORTHOPEDIC & REHABILITATION CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2019-04-23",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "251-928-2401"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528700580",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayside Orthopaedic, Sports Medicine & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bayside Orthopaedic, Sports Medicine & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.