SOUTH ALABAMA MEDICAL CLINIC, LLC – Rural Health Clinic/Center, NPI 1811288038

SOUTH ALABAMA MEDICAL CLINIC, LLC is a healthcare provider. based in Grand bay, Alabama. specializing in Rural Health Clinic/Center. The organization holds a License No. 1-072232 (AL). The NPI Number for SOUTH ALABAMA MEDICAL CLINIC, LLC is 1811288038

Main info

Organization
Name
SOUTH ALABAMA MEDICAL CLINIC, LLC
NPI
1811288038
Phone
(251) 865-1852
Address
10075 GRAND BAY WILMER RD S
Authorized Official
BRIDGOT PETERS DIRECTOR
Enumeration Date
21 April 2011
Deactivation Date
23 July 2024
Reactivation Date
31 July 2024
Last Update Date
29 August 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for SOUTH ALABAMA MEDICAL CLINIC, LLC

  • 10075 GRAND BAY WILMER RD S

    GRAND BAY, AL 365415003

    Phone: (251) 865-1852

    Fax: (251) 865-1854

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-02-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-01-31 (861 days ago).

Enrollment records

2

Earliest due date

2024-01-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20110622000356OClinic/Group PracticeAL2024-01-31
O20120214000520ORural Health ClinicAL2024-06-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36541)

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Reviews

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Frequently asked questions

What is the standard ID for SOUTH ALABAMA MEDICAL CLINIC, LLC in the U.S.?
In the U.S., SOUTH ALABAMA MEDICAL CLINIC, LLC is identified by NPI 1811288038.
Quick check: is SOUTH ALABAMA MEDICAL CLINIC, LLC active?
Public NPPES data shows SOUTH ALABAMA MEDICAL CLINIC, LLC with an active NPI status right now.
How should patients interpret SOUTH ALABAMA MEDICAL CLINIC, LLC's specialty?
The extract shows Rural Health Clinic/Center for SOUTH ALABAMA MEDICAL CLINIC, LLC. Clinical services aligned with this taxonomy classification.
What city is tied to SOUTH ALABAMA MEDICAL CLINIC, LLC?
The directory associates SOUTH ALABAMA MEDICAL CLINIC, LLC with Grand Bay, Alabama. Check all listed addresses for suites or satellite offices.
Can I export SOUTH ALABAMA MEDICAL CLINIC, LLC's record?
You can download the official NPPES record; we summarize key fields for readability.

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