Marshall County Pediatrics, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

6719 Issued in AL

Legal business name

MARSHALL COUNTY PEDIATRICS, PC

Practice address

2525 US Highway 431
Ste 104
Boaz, AL 35957-5934

Phone

(256) 571-8969

Fax

(256) 571-8980

NPI assigned

Jun 30, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Vicky Hicks

Title

Practice Management

Phone

(256) 891-5102

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Marshall County Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Marshall County Pediatrics, PC

  • Specialist
  • Guntersville, AL
  • NPI 1043242514
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1994/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1003078270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MEDICAL PARK DR",
            "address_2": "SUITE B",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359766999",
            "telephone_number": "256-571-8969",
            "fax_number": "256-571-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 US HIGHWAY 431",
            "address_2": "STE 104",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575934",
            "telephone_number": "256-571-8969",
            "fax_number": "256-571-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL COUNTY PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "VICKY",
        "authorized_official_title_or_position": "PRACTICE MANAGEMENT",
        "authorized_official_telephone_number": "256-891-5102",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "6719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1508935545",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yesenia Lopez, MD
• Abner Lynn Luther, MD
• Matt Maltbie
• Mark a. Davis, O.D.
• Mark L Turk
• Marshall ENT Hearing AIDS
• Marshall Medical Center South
• Marshall Medical Center South
• Marshall Medical Center South (Albertville Primary Care)
• Marshall Medical Center South (Tom Payne Radiation Oncologist)

• Specialist in Boaz, AL
• Providers in Boaz, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.