South Alabama Medical Clinic LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

SOUTH ALABAMA MEDICAL CLINIC LLC

Practice address

10075 Grand Bay Wilmer Rd S
Grand Bay, AL 36541-5003

Phone

(251) 865-1852

Fax

(251) 865-1854

NPI assigned

Dec 13, 2011

Last updated

Jul 23, 2024By 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

Bridgot Peters

Title

Director

Phone

(251) 865-1852

Specialties & licenses 6

Addresses

Tax ID family

South Alabama Medical Clinic2 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.

• South Alabama Medical Clinic, LLC

  • Rural Health Clinic/Center
  • Grand Bay, AL
  • NPI 1811288038
  NPD tax ID

Practitioners 1

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.

• Lloyd Sean Stokes, NP-C

  • Family Nurse Practitioner
  • Grand Bay, AL
  • NPI 1457546319
  NPD

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1386912723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10075 GRAND BAY WILMER RD S",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365415003",
            "telephone_number": "251-865-1852",
            "fax_number": "251-865-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10075 GRAND BAY WILMER RD S",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365415003",
            "telephone_number": "251-865-1852",
            "fax_number": "251-865-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ALABAMA MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "BRIDGOT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "251-865-1852"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Richardson
• Christina Roeder, PHARMD
• Deanna Walker Seaman, NP
• Taniya Smith, DO
• South Alabama Family Care, LLC
• South Alabama Medical Clinic, LLC
• Melissa Sprinkle, CRNP
• Tempestt Odessa Stanton
• Stanton's Homecare
• Justin Blake Stokes, CRNP

• Rural Health Clinic/Center in Grand Bay, AL
• Providers in Grand Bay, AL by specialty
• Rural Health Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.