Providence Hospital

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PROVIDENCE HOSPITAL

Practice address

6701 Airport Blvd BLDG B
Mobile, AL 36608-6705

Phone

(251) 266-2883

NPI assigned

Feb 24, 2021

Last updated

Feb 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathleen Hedrick

Title

Director Net Revenue Management

Phone

(205) 212-6652

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Providence Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Providence Hospital

  • Hospitalist Physician
  • Mobile, AL
  • NPI 1871922971
  NPD tax ID
• Providence Hospital

  • Anesthesiology Physician
  • Mobile, AL
  • NPI 1992133912
  NPD tax ID

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1043804628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 22ND ST S STE 1000",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352052881",
            "telephone_number": "205-212-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD BLDG B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086705",
            "telephone_number": "251-266-2883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6801 Airport Blvd",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366083785",
            "country_code": "US",
            "telephone_number": "251-266-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROVIDENCE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "DIRECTOR NET REVENUE MANAGEMENT",
        "authorized_official_telephone_number": "205-212-6652"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Healthcare Services (Providence Medical Group)
• Providence Healthcare Services Inc (Employee Health Clinic)
• Providence Healthcare Services, Inc. (Gulf Coast Dermatology and Skin Care Centre)
• Providence Healthcare SVC (Providence Open MRI)
• Providence Home Medical Services, LLC
• Providence Hospital
• Providence Hospital
• Providence Hospital
• Providence Park Rehabilitation Healthcare Center LLC
• Adrian Pruett

• Clinical Medical Laboratory in Mobile, AL
• Providers in Mobile, AL by specialty
• Clinical Medical Laboratory in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.