NPIMap

Organization Active NPI

Shoals Infectious Disease Consultants LLC

  • Infectious Disease Physician
  • Athens, AL
National Provider Identifier
1083192173
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD.36985
Legal business name
SHOALS INFECTIOUS DISEASE CONSULTANTS LLC
Practice address
22281 US Highway 72 Ste a
Athens, AL 35613-2601
Phone
(256) 444-4401
Fax
(256) 444-4403
NPI assigned
Aug 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
Jean Hilaire Vincent, MD
Title
Owner
Phone
(256) 444-4401

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WW0000X 180531025
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X MD.36985
Infectious Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0200X MD.36985 Primary

Addresses

Primary practice location

22281 US Highway 72 Ste a
Athens, AL 35613-2601

Mailing address

PO Box 1077
Florence, AL 35630
Phone (256) 444-4401

Other practice location 1

3103 Florence Blvd
Florence, AL 35634-2546
Phone (256) 444-4401

Other identifiers 1

IdentifierTypeStateIssuer
219543MedicaidAL

Other names 1

  • St. Vincent Infectious Disease and Internal Medicine Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1083192173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1077",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "35630",
            "telephone_number": "256-444-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22281 US HIGHWAY 72 STE A",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356132601",
            "telephone_number": "256-444-4401",
            "fax_number": "256-444-4403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3103 Florence Blvd",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "AL",
            "postal_code": "356342546",
            "country_code": "US",
            "telephone_number": "256-444-4401",
            "fax_number": "256-444-4403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHOALS INFECTIOUS DISEASE CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "HILAIRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-444-4401",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": "180531025",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": "MD.36985",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": "MD.36985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219543",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Vincent Infectious Disease and Internal Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.