My Psychiatry Clinic, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MY PSYCHIATRY CLINIC, LLC

Practice address

2021 Shady Crest Dr. Suite 100
Hoover, AL 35216

Phone

(205) 536-6555

Fax

(980) 414-6282

NPI assigned

Feb 14, 2020

Organization subpart

No

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

Authorized official

Name

Mohammad Aminul Islam, M.D.

Title

Ceo

Phone

(205) 536-6555

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1013540376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SHADY CREST DR. SUITE 100",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "35216",
            "telephone_number": "205-536-6555",
            "fax_number": "980-414-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SHADY CREST DR. SUITE 100",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "35216",
            "telephone_number": "205-536-6555",
            "fax_number": "980-414-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PSYCHIATRY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "ISLAM",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "AMINUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "205-536-6555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; 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.