Organization Active NPI

Eastern Medical Specialists, P.C.

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1053302497
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EASTERN MEDICAL SPECIALISTS, P.C.
Practice address
48 Medical Park Dr E
Suite 457
Birmingham, AL 35235-3400
Phone
(205) 838-3800
Fax
(205) 838-3206
NPI assigned
Nov 3, 2005
Last updated
May 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Ms. Michelle P Ronk
Title
Practice Manager
Phone
(205) 838-3800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Gastroenterology Physician 207RG0100X NU

Addresses

Primary practice location

48 Medical Park Dr E
Suite 457
Birmingham, AL 35235-3400

Mailing address

48 Medical Park Dr E
Suite 457
Birmingham, AL 35235-3400
Phone (205) 838-3800

Other identifiers 1

IdentifierTypeStateIssuer
529302120MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000404 AL Part B Supplier - Clinic/Group Practice 1355233529 Receives reassigned benefits from 2 practitioners
Practice locations: Birmingham, AL

National Provider Directory

National Provider Directory
Tax ID family
Eastern Medical Specialists2 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.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f6960be4-ec5f-4de6-8b4b-e2f3c6a9bd30/

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1053302497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E",
            "address_2": "SUITE 457",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353400",
            "telephone_number": "205-838-3800",
            "fax_number": "205-838-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E",
            "address_2": "SUITE 457",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353400",
            "telephone_number": "205-838-3800",
            "fax_number": "205-838-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN MEDICAL SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "RONK",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "205-838-3800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529302120",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.