Individual provider Active NPI

Gregory A Sharp, PA

  • Physician Assistant
  • Mobile, AL
National Provider Identifier
1639179898
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA167 Issued in AL
Practice address
580 Providence Park Dr E FL 2
Mobile, AL 36695-4614
Phone
(251) 631-3570
Fax
(251) 631-3572
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA167 AL Primary

Addresses

Primary practice location

580 Providence Park Dr E FL 2
Mobile, AL 36695-4614

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

8573 County Road 64
Daphne, AL 36526-8706
Phone (251) 621-2244

Other practice location 2

2305 Hand Ave
Bay Minette, AL 36507-4191
Phone (251) 631-3570

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address GS4122@forefrontdermatology.emadirect.md
Direct Messaging Address GS4122@forefrontdermatology.emadirect.md
Direct Messaging Address GS4122@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040116001087 AL Practitioner - Physician Assistant 2264331529 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

580 Providence Park Dr E
Mobile, AL 36695-4614
Phone (251) 631-3570

8573 County Rd
Suite 64
Daphne, AL 36526-8706
Phone (251) 621-2244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA167ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Orthopedic & Rehabilitation Center PC CurrentSince Jun 13, 2012 Accepting new patients
Forefront Dermatology, S.C. CurrentSince Jun 16, 2018 Accepting new patients
Forefront Dermatology, S.C. CurrentSince Jun 16, 2018 Accepting new patients
Bayside Orthopaedic & Rehabilitation Center, P.C. CurrentSince Jun 13, 2012 Accepting new patients
Forefront Dermatology, S.C. Past Accepting new patients
Eastern Shore Urgent Care LLC Past Accepting new patients
Cardio-Thoracic & Vascular Surgical Associates, P.C. PastSince Oct 17, 2014 Accepting new patients
Imc-Cardio-Thoracic and Vascular Surgical Associates LLC PastSince Sep 1, 2019 Accepting new patients
Coastal Anesthesia, P.C. Past Accepting new patients
Alabama Orthopaedic Clinic, PC Past Accepting new patients

Locations

2305 Hand Ave
Bay Minette, AL 36507
Phone (251) 435-1364

8573 County Road 64
Daphne, AL 36526
Phone (251) 621-2244

1622 N McKenzie St
Foley, AL 36535
Phone (251) 928-9954

580 Providence Park Dr E
Mobile, AL 36695
Phone (251) 631-3570

580 Providence Park Dr E
Fl 2
Mobile, AL 36695
Phone (251) 631-3570

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: gs4122@forefrontdermatology.emadirect.md

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1639179898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 PROVIDENCE PARK DR E FL 2",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366954614",
            "telephone_number": "251-631-3570",
            "fax_number": "251-631-3572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8573 County Road 64",
            "address_purpose": "LOCATION",
            "city": "Daphne",
            "state": "AL",
            "postal_code": "365268706",
            "country_code": "US",
            "telephone_number": "251-621-2244",
            "fax_number": "251-621-7209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2305 Hand Ave",
            "address_purpose": "LOCATION",
            "city": "Bay Minette",
            "state": "AL",
            "postal_code": "365074191",
            "country_code": "US",
            "telephone_number": "251-631-3570",
            "fax_number": "251-631-3572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARP",
        "first_name": "GREGORY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GS4122@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "8573 County Road 64",
            "city": "Daphne",
            "state": "AL",
            "country_code": "US",
            "postal_code": "365268706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GS4122@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "580 Providence Park Dr E Fl 2",
            "city": "Mobile",
            "state": "AL",
            "country_code": "US",
            "postal_code": "366954614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GS4122@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2305 Hand Ave",
            "city": "Bay Minette",
            "state": "AL",
            "country_code": "US",
            "postal_code": "365074191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.