Coosa Valley Urology, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

8767 Issued in AL

Legal business name

COOSA VALLEY UROLOGY, P.C.

Practice address

16 South Douglas Avenue
Sylacauga, AL 35150

Phone

(256) 245-2269

Fax

(256) 245-2260

NPI assigned

Apr 20, 2007

Last updated

Oct 4, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mamoun R Pacha, M.D.NPI 1871586453

Title

Owner

Phone

(256) 245-2269

Specialties & licenses 1

Addresses

Other identifiers 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Mamoun R Pacha, M.D.

  • Specialist
  • Sylacauga, AL
  • NPI 1871586453
  Authorized official Same address or phone

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1083831804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SOUTH DOUGLAS AVENUE",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "35150",
            "telephone_number": "256-245-2269",
            "fax_number": "256-245-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SOUTH DOUGLAS AVENUE",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "35150",
            "telephone_number": "256-245-2269",
            "fax_number": "256-245-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOSA VALLEY UROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "PACHA",
        "authorized_official_first_name": "MAMOUN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-245-2269",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "8767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340007817",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1910002",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529603840",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coosa Valley Homecare, LLC (Adoration Home Health)
• Coosa Valley Pediatrics
• Coosa Valley Respiratory & Home Medical, Inc.
• Coosa Valley Sports Medicine and Primary Care LLC
• Coosa Valley Surgical Associates
• Yvonne Price Copeland, LICSW
• Craddock Health Center P C
• Kendra Q Crews, P.A.
• James L Crook, MD
• Timothy A. Crump, N.P

• Specialist in Sylacauga, AL
• Providers in Sylacauga, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.