Organization Active NPI

Eastern Shore Ear, Nose & Throat Clinic, PC

  • Otolaryngology Physician
  • Fairhope, AL
National Provider Identifier
1386707339
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EASTERN SHORE EAR, NOSE & THROAT CLINIC, PC
Practice address
8096 Twin Beech Rd Unit 102
Fairhope, AL 36532-7195
Phone
(251) 928-0300
Fax
(251) 990-1898
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Dr. William B Norris, M.D.NPI 1619015328
Title
President
Phone
(251) 928-0300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

8096 Twin Beech Rd Unit 102
Fairhope, AL 36532-7195

Mailing address

8096 Twin Beech Rd Unit 102
Fairhope, AL 36532-7195
Phone (251) 928-0300

Other identifiers 1

IdentifierTypeStateIssuer
528501890MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060104000374 AL Part B Supplier - Clinic/Group Practice 2769405877 Receives reassigned benefits from 4 practitioners
Practice locations: Fairhope, 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
01D1105181Eastern Shore Ear Nose & Throat Clinc8096 Twin Beech Road, Suite 102, Fairhope, AL 36532Certificate of waiverSep 16, 2027

National Provider Directory

National Provider Directory

Locations

8096 Twin Beech Rd
Unit 102
Fairhope, AL 36532
Phone (251) 928-0300

188 Hospital Dr
Ste 101
Fairhope, AL 36532
Phone (205) 928-0300

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1386707339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8096 TWIN BEECH RD UNIT 102",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365327195",
            "telephone_number": "251-928-0300",
            "fax_number": "251-990-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8096 TWIN BEECH RD UNIT 102",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365327195",
            "telephone_number": "251-928-0300",
            "fax_number": "251-990-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE EAR, NOSE & THROAT CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-928-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528501890",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.