NPIMap

Organization Active NPI

Fairhope Pediatrics, Inc.

  • Pediatrics Physician
  • Fairhope, AL
National Provider Identifier
1740428663
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
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
Last updated
Jun 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Authorized official

Name
Leslie K Skinner, M.D.NPI 1174799704
Title
M.D./President
Phone
(251) 928-5568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 28869 AL Primary

Addresses

Primary practice location

19087B Greeno Rd
Fairhope, AL 36532-3899

Mailing address

19087 B Greeno Road
Fairhope, AL 36532
Phone (251) 928-5568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210113000243 AL Part B Supplier - Clinic/Group Practice 1658784665 Practice locations: Fairhope, AL

National Provider Directory

National Provider Directory

Locations

19087B Greeno Rd
Fairhope, AL 36532
Phone (251) 925-5568

Practitioners & affiliated clinicians

Practitioners 6

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": "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": []
}

Other providers in Fairhope, AL

Sources for this page

  • 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.