Fairhope Pediatrics, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

28869 Issued in AL

Legal business name

FAIRHOPE PEDIATRICS, INC.

Practice address

19087B Greeno Rd
Fairhope, AL 36532-3899

Phone

(251) 928-5568

Fax

(251) 928-2605

NPI assigned

Jan 30, 2009

Organization subpart

No

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

Authorized official

Name

Leslie K Skinner, M.D.

Title

M.D./President

Phone

(251) 928-5568

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kayci L Dixon, CPNP

  • Pediatric Nurse Practitioner
  • Fairhope, AL
  • NPI 1659056489
  NPD (past)
• Katie S Erdlitz, CRNP

  • Pediatric Nurse Practitioner
  • Fairhope, AL
  • NPI 1972806081
  NPD (past)
• Danielle Nicole Gilliam, MD FAAP

  • Pediatrics Physician
  • Fairhope, AL
  • NPI 1841453412
  NPD (past)
• Kelly Ray Green, M.D.

  • Pediatrics Physician
  • Fairhope, AL
  • NPI 1437249547
  NPD (past)
• Lindsey P White, CRNP

  • Pediatric Nurse Practitioner
  • Fairhope, AL
  • NPI 1508227570
  NPD (past)

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1740428663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19087 B GREENO ROAD",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "36532",
            "telephone_number": "251-928-5568",
            "fax_number": "251-928-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19087B GREENO RD",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323899",
            "telephone_number": "251-928-5568",
            "fax_number": "251-928-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRHOPE PEDIATRICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-30",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "M.D./PRESIDENT",
        "authorized_official_telephone_number": "251-928-5568",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "28869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairhope Health & Rehab, LLC
• Fairhope Health & Wellness Center
• Fairhope Internal Medicine PC
• Fairhope Modern Dental, PC
• Fairhope Pediatric Dentistry, PC
• Fairhope Pharmacy Inc.
• Fairhope Physical Therapy Services, Inc.
• Fairhope Residential LLC
• Fairhope Smiles, P.C.
• Fairhope Terrezza Group OD PC

• Pediatrics Physician in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.