Individual provider Active NPI

Sean R McBrearty, M.D.

  • Family Medicine Physician
  • Fairhope, AL
National Provider Identifier
1467751602
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35587 Issued in AL
Practice address
8367 Morphy Ave Ste B
Fairhope, AL 36532-3653
Phone
(251) 410-6334
Fax
(251) 410-6466
NPI assigned
Mar 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 052116 CO
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 35587 AL Primary

Addresses

Primary practice location

8367 Morphy Ave Ste B
Fairhope, AL 36532-3653

Mailing address

8367 Morphy Ave Ste B
Fairhope, AL 36532-3653
Phone (251) 410-6334

Other identifiers 2

IdentifierTypeStateIssuer
12050580MedicaidCO
024420OtherCOKAISER COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140825002696 CO Practitioner - Family Practice 8325296478 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35587ALMDFamily Medicine Physician
052116COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Wound Physicians of the West, P.C. Family Medicine CurrentSince Jan 16, 2017 Accepting new patients

Locations

3190 S Vaughn Way
Ste 550
Aurora, CO 80014
Phone (303) 955-8096

1960 S Fordham St
Longmont, CO 80503
Phone (719) 473-1105

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1467751602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8367 MORPHY AVE STE B",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323653",
            "telephone_number": "251-410-6334",
            "fax_number": "251-410-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8367 MORPHY AVE STE B",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323653",
            "telephone_number": "251-410-6334",
            "fax_number": "251-410-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBREARTY",
        "first_name": "SEAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-25",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "052116",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "35587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12050580",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "024420",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.