Eastern Shore Internal Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

00016922 Issued in AL

Legal business name

EASTERN SHORE INTERNAL MEDICINE, LLC

Practice address

374 Greeno Rd S
Fairhope, AL 36532-1916

Phone

(251) 990-1770

Fax

(251) 990-1771

NPI assigned

Jan 13, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Richard L. Snellgrove, M.D,NPI 1366499477

Title

Physician

Phone

(251) 990-1770

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

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

• Richard Lewis Snellgrove, MD

  • Internal Medicine Physician
  • Fairhope, AL
  • NPI 1366499477
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298246400000",
    "number": "1891090403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 GREENO RD S",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321916",
            "telephone_number": "251-990-1770",
            "fax_number": "251-990-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GREENO RD S",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321916",
            "telephone_number": "251-990-1770",
            "fax_number": "251-990-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-02-21",
        "status": "A",
        "authorized_official_last_name": "SNELLGROVE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "251-990-1770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00016922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000038007",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "510-38007",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "25-10092",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastern Shore Ear, Nose & Throat Clinic, PC
• Eastern Shore Eye Care, PC
• Eastern Shore Gastroenterology, P.C.
• Eastern Shore Health Center, LLC
• Eastern Shore Heart Center
• Eastern Shore Medical Specialists, LLC
• Eastern Shore Mental Wellness Center
• Eastern Shore Oral, Facial and Implant Surgery Center, P.C.
• Eastern Shore Orthopaedic Center, P.C.
• Eastern Shore Orthotics &

• Internal Medicine Physician in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; 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.