Organization Active NPI

Gulf Coast Pediatrics, LLC

  • Pediatrics Physician
  • Mobile, AL
National Provider Identifier
1194011288
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25929 Issued in AL
Legal business name
GULF COAST PEDIATRICS, LLC
Practice address
5675 Three Notch Rd Ste C
Mobile, AL 36619-1617
Phone
(251) 445-4440
Fax
(251) 445-4435
NPI assigned
Jun 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Authorized official

Name
Michelle K Naman, MDNPI 1285786590
Title
Managing Partner
Phone
(251) 445-4440

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 25929 AL Primary

Addresses

Primary practice location

5675 Three Notch Rd Ste C
Mobile, AL 36619-1617

Mailing address

PO Box 191178
Mobile, AL 36619-6178
Phone (251) 445-4440

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
01D2026454Gulf Coast Pediatrics LLC5675 Three Notch Road Suite C, Mobile, AL 36619Certificate of waiverJun 29, 2027

National Provider Directory

National Provider Directory

Locations

5675 Three Notch Rd
Mobile, AL 36619
Phone (251) 445-4440

5675 Three Notch Rd
#C
Mobile, AL 36619
Phone (251) 445-4440

Practitioners & affiliated clinicians

Practitioners 4

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": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391126400000",
    "number": "1194011288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191178",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366196178",
            "telephone_number": "251-445-4440",
            "fax_number": "251-445-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 THREE NOTCH RD STE C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366191617",
            "telephone_number": "251-445-4440",
            "fax_number": "251-445-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-27",
        "last_updated": "2014-01-31",
        "status": "A",
        "authorized_official_last_name": "NAMAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "251-445-4440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "25929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.