Easternshore OBGYN

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

EASTERNSHORE OBGYN

Practice address

8552 Morphy Ave
Fairhope, AL 36532-3696

Phone

(251) 928-4113

Fax

(251) 928-7177

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Mitzi M Childs, MD

Title

Physician

Phone

(251) 928-4113

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 2

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

• Lorena E Hunt, MD

  • Obstetrics & Gynecology Physician
  • Fairhope, AL
  • NPI 1558436055
  Medicare reassignment Care Compare group NPD
• Penelope Keren Richbourg, CRNP

  • Women's Health Nurse Practitioner
  • Fairhope, AL
  • NPI 1437316460
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356416879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1134",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365331134",
            "telephone_number": "251-928-4113",
            "fax_number": "251-928-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8552 MORPHY AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323696",
            "telephone_number": "251-928-4113",
            "fax_number": "251-928-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERNSHORE OBGYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "MITZI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "251-928-4113",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastern Shore Mental Wellness Center
• Eastern Shore Oral, Facial and Implant Surgery Center, P.C.
• Eastern Shore Orthopaedic Center, P.C.
• Eastern Shore Orthotics & (Hanger Clinic)
• Eastern Shore Pharmacy, LLC (Eastern Shore Pharmacy)
• Stacy Lynette Edwards, MFT-I
• Walter Le Rroy Elam III
• Element Health, Inc.
• Element of Fun, LLC
• Haley Suzanne Elkins, CRNP

• Obstetrics & Gynecology Physician in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Obstetrics & Gynecology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.