Organization Active NPI

Alabama Vascular Specialists, PC

  • Vascular Surgery Physician
  • Montgomery, AL
National Provider Identifier
1033840269
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
ALABAMA VASCULAR SPECIALISTS, PC
Practice address
2104 Chestnut St
Montgomery, AL 36106-1113
Phone
(334) 801-9952
Fax
(334) 356-4195
NPI assigned
Jun 20, 2022
Last updated
Aug 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Authorized official

Name
Dr. Ralph Redd, MDNPI 1487676045
Title
Physician
Phone
(334) 801-9952

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

2104 Chestnut St
Montgomery, AL 36106-1113

Mailing address

2104 Chestnut St
Montgomery, AL 36106-1113
Phone (334) 801-9952

Other identifiers 1

IdentifierTypeStateIssuer
1487676045OtherALVASCULAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220726002921 AL Part B Supplier - Clinic/Group Practice 5294117008 Receives reassigned benefits from 5 practitioners
Practice locations: Montgomery, AL; Selma, AL

National Provider Directory

National Provider Directory

Locations

2055 E South Blvd
Ste 403
Montgomery, AL 36116
Phone (334) 286-5500

2104 Chestnut St
Montgomery, AL 36106
Phone (334) 613-0807

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.372198

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1033840269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 CHESTNUT ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061113",
            "telephone_number": "334-801-9952",
            "fax_number": "334-356-4195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 CHESTNUT ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061113",
            "telephone_number": "334-801-9952",
            "fax_number": "334-356-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALABAMA VASCULAR SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-08-03",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "REDD",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "334-801-9952",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VASCULAR",
            "identifier": "1487676045",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.