Baldwin OB-GYN PC
Organization Active NPI Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician · Foley, AL
NPI 1295940674 · NPPES record last updated Oct 4, 2016
Key facts
- NPI
- 1295940674
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician 207VH0002X
- License
- 17877 (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
- Organization subpart
- No
Authorized official
- Name
- Judy Delacy Clousett, MD
- Title
- President
- Phone
- (251) 424-1100
Corporate family (same tax ID) 1
Practitioners 6
-
Tracy L Brown, CRNP
-
Samantha Allen McDowell, NURSE PRACTITIONER
-
Elizabeth K Hart, ALC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D1038260 | Baldwin OB GYN | Provider-performed microscopy | Mar 14, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050421000563 | AL | Part B Supplier - Clinic/Group Practice | 1456399286 |
Receives reassigned benefits from 5 practitioners Practice locations: Foley, AL |
National Provider Directory
- Tax ID family
- Baldwin OB-GYN PC
Locations
2002 Medical Center Dr
Bay Minette, AL 36507
Phone (251) 937-5377
1506 N McKenzie St
Ste 104
Foley, AL 36535
Phone (251) 424-1100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician |
207VH0002X | 17877 | AL | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 529922890 | Medicaid | AL |
Other providers in Foley, AL
- Whitley Bailey
- Janet Baker
- Baldwin Bone & Joint P C
- Baldwin County Primary Care, LLC
- Baldwin County Pulmonary and Sleep Physicians, PC
- Baldwin Optical
- Baldwin Optical and Hearing Aid Company LLC
- Anna Fulton Barnes
- Kaitlyn Barnes
- Melissa Greer Bassett-Gingras
All providers in Foley, AL · Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.