NPIMap

Organization Active NPI

Bayside Orthopaedic & Rehabilitation Center, P.C.

  • Orthopaedic Surgery Physician
  • Gulf Shores, AL
National Provider Identifier
1265053342
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BAYSIDE ORTHOPAEDIC & REHABILITATION CENTER, P.C.
Practice address
101 E 15TH Ave Ste B
Gulf Shores, AL 36542-3501
Phone
(251) 928-2401
Fax
(251) 928-5099
NPI assigned
Apr 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Authorized official

Name
Robert Stanley
Title
Ceo
Phone
(251) 928-2401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

101 E 15TH Ave Ste B
Gulf Shores, AL 36542-3501

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040709000846 AL Part B Supplier - Clinic/Group Practice 3779561410 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brewton, AL; Evergreen, AL; Fairhope, AL; Foley, AL; Gulf Shores, AL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

101 E 15th Ave
#B
Gulf Shores, AL 36542

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588204800000",
    "number": "1265053342",
    "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": "101 E 15TH AVE STE B",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365423501",
            "telephone_number": "251-928-2401",
            "fax_number": "251-928-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE ORTHOPAEDIC & REHABILITATION CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-30",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "251-928-2401"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Shores, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.