Grand Bay Convalescent Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10610 Issued in AL

Legal business name

GRAND BAY CONVALESCENT HOME INC

Practice address

13750 Highway 90 West
Grand Bay, AL 36541

Phone

(251) 865-6443

Fax

(251) 865-3610

NPI assigned

Aug 18, 2005

Organization subpart

No

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

Authorized official

Name

Jimmie L Hall

Title

Assistant Administrator

Phone

(251) 865-6443

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Kristina E Ray, MD

  • Internal Medicine Physician
  • Wilmer, AL
  • NPI 1598831422
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386636033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 328",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365410328",
            "telephone_number": "251-865-6443",
            "fax_number": "251-865-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13750 HIGHWAY 90 WEST",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "36541",
            "telephone_number": "251-865-6443",
            "fax_number": "251-865-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND BAY CONVALESCENT HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "251-865-6443"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "10610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4752110S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quyen Pham Chuong, PHARM. D
• Gail L Cook
• Tina Crane, PMHNP-BC
• Penny Xuan Dupre, M.D.
• Vantrell Terrell Fox
• Grand Bay Medical Center, Inc.
• Greenway Health and Rehabilitation Center LLC
• Gregory L. Kennedy D.M.D PC
• Gulf Coast Treatment Center
• Hart & Associates

• Skilled Nursing Facility in Grand Bay, AL
• Providers in Grand Bay, AL by specialty
• Skilled Nursing Facility 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.