Patriot Healthcare of Alabama, LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

PATRIOT HEALTHCARE OF ALABAMA, LLC

Doing business as

PHC of AL Brookwood

Practice address

2045 Brookwood Medical Center Drive
Suite 1
Birmingham, AL 35209

Phone

(205) 381-0011

NPI assigned

Nov 15, 2018

Organization subpart

No

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

Authorized official

Name

David A. Culver

Title

Administrator

Phone

(904) 825-4368

Specialties & licenses 1

Addresses

Other names 1

• PHC of AL Brookwood Doing business as

Tax ID family

Patriot Healthcare of Alabama LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Patriot Healthcare of Alabama, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Birmingham, AL
  • NPI 1225507692
  NPD tax ID

Locations

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1093284457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ARRICOLA AVENUE",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32080",
            "telephone_number": "904-825-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 BROOKWOOD MEDICAL CENTER DRIVE",
            "address_2": "SUITE 1",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-381-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRIOT HEALTHCARE OF ALABAMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "CULVER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-825-4368"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHC of AL Brookwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia A Patrician, RN
• Patrick Ifediba MD LLC
• Alyssa Patrick, PHARM D
• Kelly Patrick, R.D.
• Madison Michelle Patrick
• Patriot Healthcare of Alabama, LLC
• Patsy Rhodes
• Carter Joshua Patten
• Jason R Patten, M.D.
• Katherine Nicole Patten, DPT

• Geriatric Medicine (Family Medicine) Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Geriatric Medicine (Family Medicine) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.