Organization Active NPI

Baldwin OB-GYN PC

  • Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
  • Foley, AL
National Provider Identifier
1295940674
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VH0002X
License
17877 Issued in AL
Legal business name
BALDWIN OB-GYN PC
Practice address
1506 N McKenzie Street
Suite 104
Foley, AL 36535-2264
Phone
(251) 424-1100
Fax
(251) 424-1110
NPI assigned
May 11, 2007
Last updated
Oct 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Authorized official

Name
Judy Delacy Clousett, MD
Title
President
Phone
(251) 424-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VH0002X 17877 AL Primary

Addresses

Primary practice location

1506 N McKenzie Street
Suite 104
Foley, AL 36535-2264

Mailing address

1506 N McKenzie Street
Suite 104
Foley, AL 36535-2264
Phone (251) 424-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050421000563 AL Part B Supplier - Clinic/Group Practice 1456399286 Receives reassigned benefits from 5 practitioners
Practice locations: Foley, AL

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
01D1038260Baldwin OB GYN1506 N McKenzie St Suite 104, Foley, AL 36535Provider-performed microscopyMar 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Baldwin OB-GYN PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2305 Hand Ave
Ste 4
Bay Minette, AL 36507
Phone (251) 580-4600

1506 N McKenzie St
Foley, AL 36535
Phone (251) 219-4175

1506 N McKenzie St
Ste 104
Foley, AL 36535
Phone (251) 424-1100

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1295940674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 N MCKENZIE STREET",
            "address_2": "SUITE 104",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352264",
            "telephone_number": "251-424-1100",
            "fax_number": "251-424-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 N MCKENZIE STREET",
            "address_2": "SUITE 104",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352264",
            "telephone_number": "251-424-1100",
            "fax_number": "251-424-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALDWIN OB-GYN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "CLOUSETT",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "DELACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-424-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "AL",
            "license": "17877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.