NPIMap

Organization Active NPI

Grand Bay Medical Center, Inc.

  • Rural Health Clinic/Center
  • Grand Bay, AL
National Provider Identifier
1558570978
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GRAND BAY MEDICAL CENTER, INC.
Practice address
10075 Grand Bay Wilmer Rd S
Grand Bay, AL 36541-5003
Phone
(251) 865-9111
NPI assigned
May 22, 2007
Last updated
Mar 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Authorized official

Name
Mr. Greg Shoemaker
Title
Assoc. Admin. of Bus. Development
Phone
(228) 497-7909

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

10075 Grand Bay Wilmer Rd S
Grand Bay, AL 36541-5003

Mailing address

2012 Highway 90
Suite 34
Gautier, MS 39553-5306

National Provider Directory

National Provider Directory

Locations

10075 Grand Bay Wilmer Rd S
#R
Grand Bay, AL 36541
Phone (251) 865-1852

Practitioners & affiliated clinicians

Practitioners 10

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1558570978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 HIGHWAY 90",
            "address_2": "SUITE 34",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10075 GRAND BAY WILMER RD S",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365415003",
            "telephone_number": "251-865-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND BAY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "ASSOC. ADMIN. OF BUS. DEVELOPMENT",
        "authorized_official_telephone_number": "228-497-7909",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Bay, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.