Individual provider Active NPI

Barbara Coon Favreau, PA-C

  • Medical Physician Assistant
  • Mobile, AL
National Provider Identifier
1962649574
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
617 Issued in AL
Practice address
2350 Schillinger Road South
Suite a
Mobile, AL 36695
Phone
(251) 633-0123
Fax
(251) 410-6127
NPI assigned
Jan 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 617 AL Primary

Addresses

Primary practice location

2350 Schillinger Road South
Suite a
Mobile, AL 36695

Mailing address

PO Box 7627
Mobile, AL 36670-0627
Phone (251) 633-7211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090520000101 AL Practitioner - Physician Assistant 1658420724 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Alabama College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gmuc of Citronelle LLCGroup PAC ID 8426210014, 11 clinicians
Greater Mobile Urgent CareGroup PAC ID 1456429281, 50 clinicians

Practice addresses (Care Compare)

19355 N 3Rd St
Citronelle, AL 36522-2049
Phone (251) 633-0123

7943 Moffett Rd
Semmes, AL 36575-5409
Phone (251) 633-0123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Mobile Urgent Care CurrentSince Sep 3, 2019 Accepting new patients

Locations

19355 N 3rd St
Ste 104
Citronelle, AL 36522
Phone (251) 633-0123

4402 Old Shell Rd
Mobile, AL 36608
Phone (251) 633-0123

2350 Schillinger Rd S
Ste A
Mobile, AL 36695
Phone (251) 633-0123

1114 Shelton Beach Rd
Saraland, AL 36571
Phone (251) 633-0123

7943 Moffett Rd
Semmes, AL 36575
Phone (251) 445-7618

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1962649574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7627",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366700627",
            "telephone_number": "251-633-7211",
            "fax_number": "251-410-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 SCHILLINGER ROAD SOUTH",
            "address_2": "SUITE A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36695",
            "telephone_number": "251-633-0123",
            "fax_number": "251-410-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVREAU",
        "first_name": "BARBARA",
        "middle_name": "COON",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.