NPIMap

Organization Active NPI

Marshall Medical Center South Diamond Hospital Services

  • Family Medicine Physician
  • Boaz, AL
National Provider Identifier
1063741841
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARSHALL MEDICAL CENTER SOUTH DIAMOND HOSPITAL SERVICES
Practice address
2505 US Highway 431
Boaz, AL 35957
Phone
(256) 593-8310
NPI assigned
Dec 8, 2009
Last updated
Apr 26, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MARSHALL MEDICAL CENTER SOUTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Dalton Diamond, MDNPI 1063471910
Title
Physician
Phone
(256) 593-8310

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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2505 US Highway 431
Boaz, AL 35957

Mailing address

P.O. Box 11407
Dept 1572
Birmingham, AL 35246-1572
Phone (256) 593-8310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120717000283 AL Part B Supplier - Clinic/Group Practice 7012173289 Receives reassigned benefits from 10 practitioners
Practice locations: Boaz, AL; Guntersville, AL

National Provider Directory

National Provider Directory
Part of
Boaz-Albertville Hospital

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1063741841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 11407",
            "address_2": "DEPT 1572",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352461572",
            "telephone_number": "256-593-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 US HIGHWAY 431",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "35957",
            "telephone_number": "256-593-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL MEDICAL CENTER SOUTH DIAMOND HOSPITAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARSHALL MEDICAL CENTER SOUTH",
        "enumeration_date": "2009-12-08",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "DALTON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "256-593-8310",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boaz, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.