NPIMap

Organization Active NPI

Children's Medical Group, P.a.

  • Specialist
  • Mobile, AL
National Provider Identifier
1689639312
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CHILDREN'S MEDICAL GROUP, P.A.
Practice address
3920 Airport Blvd
Mobile, AL 36608-2207
Phone
(251) 342-3810
Fax
(251) 344-6752
NPI assigned
Apr 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Fred L Shell Jr.
Title
Business Manager
Phone
(251) 342-3810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3920 Airport Blvd
Mobile, AL 36608-2207

Mailing address

3920 Airport Blvd
Mobile, AL 36608-2207
Phone (251) 342-3810

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0305760Children's Medical Group3920 Airport Blvd, Mobile, AL 36608ComplianceMay 16, 2028

National Provider Directory

National Provider Directory

Locations

3920 Airport Blvd
Ste A
Mobile, AL 36608

610 Providence Park Dr E
Ste 201
Mobile, AL 36695
Phone (251) 639-1300

Practitioners & affiliated clinicians

Practitioners 11

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": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689639312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366082207",
            "telephone_number": "251-342-3810",
            "fax_number": "251-344-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366082207",
            "telephone_number": "251-342-3810",
            "fax_number": "251-344-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHELL",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "251-342-3810",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.