NPIMap

Organization Active NPI

University of Alabama at Birmingham

Doing business as UAB Department of Family Medicine

  • Family Medicine Physician
  • Birmingham, AL
National Provider Identifier
1063576858
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY OF ALABAMA AT BIRMINGHAM
Doing business as
UAB Department of Family Medicine
Practice address
930 20TH St S
Suite 325
Birmingham, AL 35205-2610
Phone
(205) 934-9700
Fax
(205) 975-6962
NPI assigned
Dec 19, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF ALABAMA AT BIRMINGHAMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mrs. Tyra Johnson-Pirtle, C.P.A
Title
Administrator
Phone
(205) 934-1598

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

930 20TH St S
Suite 325
Birmingham, AL 35205-2610

Mailing address

930 20TH St S
Suite 325
Birmingham, AL 35205-2610
Phone (205) 934-9700

Other names 1

  • UAB Department of Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000323 AL Part B Supplier - Clinic/Group Practice 3779487970 Receives reassigned benefits from 457 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Birmingham, AL; Selma, AL; Montgomery, AL

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
OB GYN Research Diagnos48 organizations share this tax ID, including this one
Part of
OB GYN Research Diagnos

Other organizations with this tax ID 47

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

View all 47

Locations

930 20th St S
Ste 325
Birmingham, AL 35205
Phone (205) 934-9700

Practitioners & affiliated clinicians

Practitioners 4

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": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1063576858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 20TH ST S",
            "address_2": "SUITE 325",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352052610",
            "telephone_number": "205-934-9700",
            "fax_number": "205-975-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 20TH ST S",
            "address_2": "SUITE 325",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352052610",
            "telephone_number": "205-934-9700",
            "fax_number": "205-975-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ALABAMA AT BIRMINGHAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF ALABAMA AT BIRMINGHAM",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-PIRTLE",
        "authorized_official_first_name": "TYRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "205-934-1598",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "C.P.A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UAB Department of Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 20, 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.