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PROVIDENCE MEDICAL GROUP - GULF SHORES
NPI 1093174286
General Practice in Gulf Shores, AL

Active since February 16, 2016
1700 W 2ND ST, GULF SHORES, AL 36542(251) 342-3949(251) 631-3361 Get Directions Write a Review

NPPES record last updated: February 16, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Providence Medical Group - Gulf Shores NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE MEDICAL GROUP - GULF SHORES (NPI 1093174286) is a healthcare organization registered as a general practice in Gulf Shores, Alabama and active in the NPI registry since February 2016. The organization lists Todd Kennedy, President, as its authorized official.

NPPES Registry Identity

NPI1093174286
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameALABAMA PROVIDENCE HEALTHCARE SERVICES
Location Address1700 W 2ND STGulf Shores, AL 36542-3422
Mailing Address6701 Airport Blvd, Suite 143Mobile, AL 36608-6705 · (251) 342-3949 · Fax (251) 631-3361
Phone(251) 342-3949
Fax(251) 631-3361
Organization SubpartNo
Authorized OfficialTodd KennedyPresident · (251) 633-8880
Enumeration DateFebruary 16, 2016
✔ NPI 1093174286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

1700 W 2ND ST, Gulf Shores, AL 36542
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Other Names 1

Doing Business AsProvidence Medical Group - Gulf Shores

Other Identifiers 2

Medicaid156183AL
Medicare UPIN102G702814AL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIN DEWRELL PRENDERGAST ARNP
Nurse Practitioner (Family)
1700 W 2ND ST
GULF SHORES, AL 36542
Baldwin County (251) 967-4000
NICOLE M BODINE CRNP
Nurse Practitioner (Family)
1700 W 2ND ST
GULF SHORES, AL 36542
Baldwin County (251) 967-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alabama Providence Healthcare Services's NPI number?

The NPI number for Alabama Providence Healthcare Services is 1093174286. It was assigned to this organization in the NPPES registry on February 16, 2016.

Where is Alabama Providence Healthcare Services located?

Alabama Providence Healthcare Services is located at 1700 W 2nd St, Gulf Shores, AL 36542. The listed phone number is (251) 342-3949.

What is Alabama Providence Healthcare Services's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Alabama Providence Healthcare Services was last updated on February 16, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.