OrganizationActiveAccepts Medicare
Eastern Shore Chiropractic & Sports Clinic, Inc
NPI 1679809644 · Chiropractor · Fairhope, AL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1679809644
- Entity type
- Organization
- Primary specialty
- ChiropractorChiropractic Providers
- Organization subpart
- No
- Authorized official
- Justin Southall, President/Owner(225) 274-5507
- License
- 2292 (AL)
Specialties & taxonomies
Chiropractic Providers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
151 Fly Creek Avenue
Suite 411
Fairhope, AL 36532-3843
Phone: (225) 274-5507
Approximate (ZIP-level) locationGet directions
Mailing address
151 Fly Creek Avenue
Fairhope, AL 36532-3843
Registry dates
- Enumerated
- 2009-10-27
- Last updated
- 2009-10-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.