NPIMap

Organization Active NPI

Gardenia Cove Mental Health PC

  • Psychiatry Physician
  • Montgomery, AL
National Provider Identifier
1063912301
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD.34291 Issued in AL
Legal business name
GARDENIA COVE MENTAL HEALTH PC
Practice address
6771 Taylor Circle
Montgomery, AL 36117
Phone
(334) 954-6010
NPI assigned
Feb 13, 2018
Last updated
Feb 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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

Authorized official

Name
Amanda Jean WilliamsNPI 1740577840
Title
Owner, MD
Phone
(334) 954-6010

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
Psychiatry Physician 2084P0800X MD.34291 AL Primary

Addresses

Primary practice location

6771 Taylor Circle
Montgomery, AL 36117

Mailing address

6771 Taylor Cir
Montgomery, AL 36117-3417
Phone (334) 954-6010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180430002176 AL Part B Supplier - Clinic/Group Practice 0648534537 Receives reassigned benefits from 45 practitioners
Practice locations: Montgomery, AL; Opelika, AL

National Provider Directory

National Provider Directory

Locations

6719 Taylor Cir
Montgomery, AL 36117
Phone (334) 954-6010

6767 Taylor Cir
Montgomery, AL 36117
Phone (334) 409-0035

6771 Taylor Cir
Montgomery, AL 36117
Phone (334) 954-6010

7177 Halcyon Summit Dr
Montgomery, AL 36117
Phone (334) 244-3408

7475 Halcyon Pointe Dr
Montgomery, AL 36117
Phone (334) 954-6010

3101 Frederick Rd
Ste 1
Opelika, AL 36801
Phone (334) 954-6010

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518480000000",
    "number": "1063912301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6771 TAYLOR CIR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173417",
            "telephone_number": "334-954-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6771 TAYLOR CIRCLE",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36117",
            "telephone_number": "334-954-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDENIA COVE MENTAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER, MD",
        "authorized_official_telephone_number": "334-954-6010"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "MD.34291",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 13, 2018; 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.