Organization Active NPI

Self and Self Company, LLC

  • Adult Medicine Physician
  • Fairhope, AL
National Provider Identifier
1174869820
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
SELF AND SELF COMPANY, LLC
Practice address
306 Greeno Rd S
Suite a
Fairhope, AL 36532-1905
Phone
(251) 928-8760
Fax
(251) 928-7028
NPI assigned
Dec 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Authorized official

Name
Karl Stanley Self, M.D.
Title
Owner/President
Phone
(251) 928-8760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

306 Greeno Rd S
Suite a
Fairhope, AL 36532-1905

Mailing address

306 Greeno Rd S
Suite a
Fairhope, AL 36532-1905
Phone (251) 928-8760

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1174869820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 GREENO RD S",
            "address_2": "SUITE A",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321905",
            "telephone_number": "251-928-8760",
            "fax_number": "251-928-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 GREENO RD S",
            "address_2": "SUITE A",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321905",
            "telephone_number": "251-928-8760",
            "fax_number": "251-928-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF AND SELF COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-28",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "STANLEY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "251-928-8760",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "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 Mar 17, 2015; 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.