Covington Pediatrics PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

COVINGTON PEDIATRICS PA

Practice address

614 W Bypass
Andalusia, AL 36420-4731

Phone

(334) 222-0119

Fax

(334) 427-9522

NPI assigned

Aug 4, 2006

Last updated

Mar 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gabrielle Baldwin, M.D.NPI 1528150521

Title

Owner

Phone

(334) 222-3555

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336157353. Details of each certification follow.

• CCN 013884 Rural health clinic · Terminated · Details

Rural health clinic certification: CCN 013884

Legal name

COVINGTON PEDIATRICS PA

Doing business as

COVINGTON PEDIATRICS RURAL HEALTH

Certification status

Terminated Voluntary: merger or closure, Nov 1, 2024

Provider type (POS)

Rural health clinic

Participating since

Nov 13, 1996

Last certification

Apr 26, 2018

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

May 15, 1992 in AL

Enrollment address

614 W Bypass
Andalusia, AL 36420-4731

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Covington Pediatrics PA

  • Pediatrics Physician
  • Andalusia, AL
  • NPI 1093731242

  3072571413

  Same PAC ID

Tax ID family

Covington Pediatrics2 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.

• Covington Pediatrics PA

  • Pediatrics Physician
  • Andalusia, AL
  • NPI 1093731242
  NPD tax ID

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Gabrielle G Baldwin, MD

  • Pediatric Adolescent Medicine Physician
  • Andalusia, AL
  • NPI 1528150521

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership

Practitioners 2

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.

• Gabrielle G Baldwin, MD

  • Pediatric Adolescent Medicine Physician
  • Andalusia, AL
  • NPI 1528150521
  NPD Authorized official
• Charles E Eldridge, MD

  • Pediatric Adolescent Medicine Physician
  • Andalusia, AL
  • NPI 1629160635
  NPD

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1336157353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 W BYPASS",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364204731",
            "telephone_number": "334-222-0119",
            "fax_number": "334-427-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 W BYPASS",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364204731",
            "telephone_number": "334-222-0119",
            "fax_number": "334-427-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINGTON PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "GABRIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-222-3555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "541003884",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Covington County Health Dept-Andalusia VFC Immun
• Covington Gynecology, P.C.
• Covington Imaging Center
• Covington Medical Associates, P.C.
• Covington Pediatrics PA
• Covington Spine Center, Inc.
• Covington Womens Healthcare LLC
• Lindsey Crutchfield
• Coralea V Dalrymple, LPC
• David Stephen Darby, RPH

• Pediatrics Physician in Andalusia, AL
• Providers in Andalusia, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.