NPIMap

Organization Active NPI

Imc-Eastern Shore Adult Medicine, LLC

  • Internal Medicine Physician
  • Fairhope, AL
National Provider Identifier
1912284852
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IMC-EASTERN SHORE ADULT MEDICINE, LLC
Practice address
300 Greeno Rd S
Suite B
Fairhope, AL 36532-1905
Phone
(251) 929-3424
Fax
(251) 929-3430
NPI assigned
Nov 7, 2011
Last updated
Jul 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Authorized official

Name
Phillip L Cowart
Title
VP Finance
Phone
(251) 435-1361

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Pulmonary Disease Physician 207RP1001X

Addresses

Primary practice location

300 Greeno Rd S
Suite B
Fairhope, AL 36532-1905

Mailing address

300 Greeno Rd S Ste B
Fairhope, AL 36532-1905
Phone (251) 929-3424

Other practice location 1

3 Medical Park
Fairhope, AL 36532-1804
Phone (251) 928-8804

Other practice location 2

188 Hospital Dr Ste 300
Fairhope, AL 36532-2038
Phone (251) 990-1910

Other practice location 3

350 Cypress Bend Blvd Ste 104
Gulf Shores, AL 36542-9190
Phone (251) 967-7690

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111207000620 AL Part B Supplier - Clinic/Group Practice 3375718042 Receives reassigned benefits from 23 practitioners
Practice locations: Fairhope, AL; Robertsdale, AL; Gulf Shores, AL; Foley, AL

National Provider Directory

National Provider Directory

Locations

188 Hospital Dr
Fairhope, AL 36532
Phone (251) 971-3555

300 Greeno Rd S
#B
Fairhope, AL 36532
Phone (251) 929-3424

350 Cypress Bend Blvd
Ste 104
Gulf Shores, AL 36542
Phone (251) 929-3424

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1912284852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GREENO RD S STE B",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321905",
            "telephone_number": "251-929-3424",
            "fax_number": "251-929-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GREENO RD S",
            "address_2": "SUITE B",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321905",
            "telephone_number": "251-929-3424",
            "fax_number": "251-929-3430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Medical Park",
            "address_purpose": "LOCATION",
            "city": "Fairhope",
            "state": "AL",
            "postal_code": "365321804",
            "country_code": "US",
            "telephone_number": "251-928-8804",
            "fax_number": "251-990-9379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "188 Hospital Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fairhope",
            "state": "AL",
            "postal_code": "365322038",
            "country_code": "US",
            "telephone_number": "251-990-1910",
            "fax_number": "251-990-1911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Cypress Bend Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Gulf Shores",
            "state": "AL",
            "postal_code": "365429190",
            "country_code": "US",
            "telephone_number": "251-967-7690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IMC-EASTERN SHORE ADULT MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-07",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "COWART",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "251-435-1361"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 24, 2026; 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.