Espt Fairhope LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ESPT FAIRHOPE LLC

Practice address

924 Plantation Blvd Ste B
Fairhope, AL 36532-7308

Phone

(251) 928-0600

NPI assigned

May 24, 2018

Organization subpart

No

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

Authorized official

Name

Brian M Lackey, PTNPI 1871580746

Title

President

Phone

(251) 928-0600

Specialties & licenses 1

Addresses

Other names 1

• Eastern Shore Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

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

• Brian Michael Lackey, P.T,

  • Physical Therapist
  • Fairhope, AL
  • NPI 1871580746

  AL, Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1396236378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 PECAN AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321226",
            "telephone_number": "251-401-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 PLANTATION BLVD STE B",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365327308",
            "telephone_number": "251-928-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESPT FAIRHOPE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "LACKEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-928-0600",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Shore Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cecil Lawrence Ennis, M.D.
• Epiphany Women'S Health
• Katie S Erdlitz, CRNP
• Christine N Erickson
• Richard Henry Esham II, DMD
• Jessica Etheredge, M.S., BCBA
• Aniekeme Saturday Etuk, MD
• David J. Eurgil II, CRNA
• Leslie Logan Evans, MD
• Everette Counseling, LLC

• All providers in Fairhope, AL
• Physical Therapy Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.