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
Last updated
Jan 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Authorized official

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

Specialties & licenses 1

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

Addresses

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "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.