Bayside Orthopaedic & Rehabilitation Center, P.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

BAYSIDE ORTHOPAEDIC & REHABILITATION CENTER, P.C.

Doing business as

Bayside Orthopaedic, Sports Medicine & Rehabilitation Center

Practice address

100 Lewis St
Evergreen, AL 36401-3317

Phone

(251) 928-2401

Fax

(251) 928-5099

NPI assigned

Aug 30, 2011

Last updated

Jan 29, 2019By 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

Rachel L Ellis

Title

Office Manager

Phone

(251) 928-2401

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Bayside Orthopaedic, Sports Medicine & Rehabilitation Center Doing business as

Tax ID family

Bayside Orthopaedic Sports Medicine Rehabilitation Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bayside Orthopaedic & Rehabilitation Center, P.C.

  dba Bayside Orthopaedic, Sports Medicine & Rehabilitation Center

  • Orthopaedic Surgery Physician
  • Bay Minette, AL
  • NPI 1962783472
  NPD tax ID

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.

• Sean Q. Fisk, P.A.

  • Physician Assistant
  • Fairhope, AL
  • NPI 1609874791
  NPD (past)

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548720000000",
    "number": "1578844080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1186",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365331186",
            "telephone_number": "251-928-2401",
            "fax_number": "251-928-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LEWIS ST",
            "city": "EVERGREEN",
            "state": "AL",
            "postal_code": "364013317",
            "telephone_number": "251-928-2401",
            "fax_number": "251-928-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE ORTHOPAEDIC & REHABILITATION CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2019-01-29",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "251-928-2401"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528700580",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayside Orthopaedic, Sports Medicine & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bayside Orthopaedic, Sports Medicine & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthopaedic Surgery Physician in Evergreen, AL
• Providers in Evergreen, AL by specialty
• Orthopaedic Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.