NPIMap

Organization Active NPI

University of South Alabama Health Care Authority

Doing business as Mobile Diagnostic Center - Midtown

  • Internal Medicine Physician
  • Mobile, AL
National Provider Identifier
1093316259
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY
Doing business as
Mobile Diagnostic Center - Midtown
Practice address
2505 Old Shell Rd
Mobile, AL 36607-3021
Phone
(251) 660-6400
Fax
(251) 660-6401
NPI assigned
Nov 4, 2020
Last updated
Apr 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Authorized official

Name
Erica Madison
Title
Credentialing
Phone
(251) 318-2681

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X

Addresses

Primary practice location

2505 Old Shell Rd
Mobile, AL 36607-3021

Mailing address

3929-1 Airport Blvd
5TH Floor, Room 513
Mobile, AL 36609
Phone (251) 318-2681

Other names 1

  • Mobile Diagnostic Center - Midtown Doing business as

National Provider Directory

National Provider Directory
Tax ID family
University of South Alab18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

2503 Old Shell Rd
Mobile, AL 36607
Phone (251) 660-6400

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1093316259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929-1 AIRPORT BLVD",
            "address_2": "5TH FLOOR, ROOM 513",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36609",
            "telephone_number": "251-318-2681",
            "fax_number": "251-378-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 OLD SHELL RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073021",
            "telephone_number": "251-660-6400",
            "fax_number": "251-660-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-04",
        "last_updated": "2021-04-08",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "251-318-2681"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Diagnostic Center - Midtown",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mobile Diagnostic Center - Midtown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.