Organization Active NPI

Shoals Obstetrics and Gynecology LLC

  • Obstetrics & Gynecology Physician
  • Florence, AL
National Provider Identifier
1083042709
Registry record updated Oct 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SHOALS OBSTETRICS AND GYNECOLOGY LLC
Practice address
1751 Veterans Dr Ste 205
Florence, AL 35630-4929
Phone
(256) 766-2600
Fax
(256) 768-8658
NPI assigned
Oct 15, 2013
Last updated
Oct 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

1751 Veterans Dr Ste 205
Florence, AL 35630-4929

Mailing address

541 W College St Ste 2600
Florence, AL 35630-5365
Phone (256) 766-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140203001233 AL Part B Supplier - Clinic/Group Practice 6103055603 Receives reassigned benefits from 4 practitioners
Practice locations: Florence, AL

National Provider Directory

National Provider Directory

Locations

1751 Veterans Dr
Ste 205A
Florence, AL 35630
Phone (256) 766-2600

3115 Northington Ct
Ste 138
Florence, AL 35630
Phone (334) 678-1430

541 W College St
Ste 2600
Florence, AL 35630
Phone (256) 766-1600

Practitioners & affiliated clinicians

Practitioners 11

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": "1381795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728777600000",
    "number": "1083042709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 W COLLEGE ST STE 2600",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305365",
            "telephone_number": "256-766-2600",
            "fax_number": "256-383-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 VETERANS DR STE 205",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356304929",
            "telephone_number": "256-766-2600",
            "fax_number": "256-768-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOALS OBSTETRICS AND GYNECOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-15",
        "last_updated": "2024-10-13",
        "certification_date": "2024-10-13",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2024; 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.