Surgical Associates of Eastern Shore PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SURGICAL ASSOCIATES OF EASTERN SHORE PC

Practice address

767 Middle St
Fairhope, AL 36532

Phone

(251) 990-9191

Fax

(251) 990-9189

NPI assigned

Oct 3, 2006

Last updated

May 18, 2016By 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

Jimmie G Gavras, MDNPI 1649255886

Title

Physician

Phone

(251) 990-9191

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Jimmie G Gavras, MD

  • Surgery Physician
  • Fairhope, AL
  • NPI 1649255886
  Authorized official Same address or phone

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1528153053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 MIDDLE ST",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "36532",
            "telephone_number": "251-990-9191",
            "fax_number": "251-990-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 MIDDLE ST",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "36532",
            "telephone_number": "251-990-9191",
            "fax_number": "251-990-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES OF EASTERN SHORE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "GAVRAS",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "251-990-9191",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529702280",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.