Organization Active NPI

Coastal Neurologic Institute

  • Physician Assistant
  • Spanish Fort, AL
National Provider Identifier
1508303280
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
COASTAL NEUROLOGIC INSTITUTE
Practice address
30762 State Highway 181
Spanish Fort, AL 36527-5672
Phone
(205) 382-0908
NPI assigned
Jan 19, 2017
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Ms. Sidney Lynn McClendon, PA-C
Title
Physician Assistant
Phone
(205) 382-0908

Practitioners 2

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

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X AL Primary

Addresses

NPPES NPI Registry

Primary practice location

30762 State Highway 181
Spanish Fort, AL 36527-5672

Mailing address

30762 State Highway 181
Spanish Fort, AL 36527-5672
Phone (205) 382-0908

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 19, 2017.

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1508303280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30762 STATE HIGHWAY 181",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275672",
            "telephone_number": "205-382-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30762 STATE HIGHWAY 181",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275672",
            "telephone_number": "205-382-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL NEUROLOGIC INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "MCCLENDON",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "205-382-0908",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fort, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.