NPIMap

Organization Active NPI

Tennessee Valley Gastroenterology

  • Gastroenterology Physician
  • Florence, AL
National Provider Identifier
1093851313
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
TENNESSEE VALLEY GASTROENTEROLOGY
Practice address
416 N. Seminary Street
Ste 3100
Florence, AL 35630
Phone
(256) 766-8667
Fax
(256) 767-5327
NPI assigned
Jan 30, 2007
Last updated
May 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Authorized official

Name
Dr. Jason Wilkes, M.D.NPI 1083657688
Title
Owner/Physician
Phone
(256) 766-8667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 00006975 AL
Gastroenterology Physician 207RG0100X AL Primary

Addresses

Primary practice location

416 N. Seminary Street
Ste 3100
Florence, AL 35630

Mailing address

416 N. Seminary Street
Suite 3100
Florence, AL 35630
Phone (256) 766-8667

Other identifiers 2

IdentifierTypeStateIssuer
529919960MedicaidAL
051521216MedicaidAL

National Provider Directory

National Provider Directory

Locations

416 N Seminary St
Ste 3100
Florence, AL 35630
Phone (256) 766-8667

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1093851313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N. SEMINARY STREET",
            "address_2": "SUITE 3100",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "35630",
            "telephone_number": "256-766-8667",
            "fax_number": "256-767-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N. SEMINARY STREET",
            "address_2": "STE 3100",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "35630",
            "telephone_number": "256-766-8667",
            "fax_number": "256-767-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE VALLEY GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "WILKES",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "256-766-8667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "00006975",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529919960",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051521216",
            "state": "AL"
        }
    ],
    "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 May 9, 2017; 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.