Southeast Diabetes, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

20092586 Issued in AL

Legal business name

SOUTHEAST DIABETES, INC.

Practice address

11 Inverness Center Pkwy
Birmingham, AL 35242-4823

Phone

(205) 783-5111

Fax

(888) 470-6890

NPI assigned

Feb 17, 2009

Last updated

Jan 20, 2023By 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

Mr. John Carter

Title

Owner/Operator

Phone

(205) 783-5111

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1093954844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 INVERNESS CENTER PKWY STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352424823",
            "telephone_number": "205-783-5111",
            "fax_number": "888-470-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 INVERNESS CENTER PKWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352424823",
            "telephone_number": "205-783-5111",
            "fax_number": "888-470-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST DIABETES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-17",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "205-783-5111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "20092586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196916",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Mullady Southall, PA
• Kyle Southall
• Madelaine Stanback Southall
• Southeast Anesthesia Associates, LLC
• Southeast Clinical Laboratories LLC
• Southeast Medical Group LLC
• Southeast Rehab Medicine Inc
• Southeast Systemic Therapy and Consulting
• Southeaster Ocular Prosthetics
• Southeastern Brace, LLC (Alabama Pain Physicians)

• Durable Medical Equipment & Medical Supplies in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Durable Medical Equipment & Medical Supplies in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.