Island Medical Alabama LLC
Organization Active NPI Emergency Medicine Physician · Cullman, AL
NPI 1104097666 · NPPES record last updated Feb 24, 2023
Key facts
- NPI
- 1104097666
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- ISLAND MEDICAL ALABAMA LLC
- Practice address
- 1912 Al Highway 157
Cullman, AL 35058-0609 - Phone
- (844) 474-4019
- NPI assigned
- Mar 12, 2008
- Organization subpart
- No
Authorized official
- Name
- Melissa Reese
- Title
- Provider Enrollment Officer
- Phone
- (855) 687-0618
Practitioners 153
-
Jonathan Borella, CRNP
-
Mark H Christensen, M.D.
-
Delana Cole Clemons, NP-C
-
Dewight Cowley Jr., M.D., MPH
-
Eric Tucker Crampsey, CRNP
-
Kim A Driggers, NP
-
Rachel Michelle Giyanani, M.D.
-
Audrey Kos, MD
-
Jennifer Lacey, CRNP
-
Donald Carlin Tighe Jr., D.O.
-
Shannon Caliri, DO
-
Roy Ferraiuolo, MD
-
Aaron L High, M.D.
-
Eric McLaine, DO
-
James Christopher Allen, CRNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080515000492 | AL | Part B Supplier - Clinic/Group Practice | 3072682103 |
Receives reassigned benefits from 136 practitioners Practice locations: Cullman, AL; Hartselle, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | AL | Yes |
Addresses
Primary practice location
1912 Al Highway 157
Cullman, AL 35058-0609
Mailing address
4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 994-4409
Other providers in Cullman, AL
- Internal Medicine and Pediatrics of Cullman
- Internal Medicine Associates of Cullman PC
- Anna Usaha Intraboona
- Marsha Anita Irvin
- Victoria Barker Isbell
- Island Medical Perseus LLC
- Jessica Lynn Jackson
- Kara Jackson
- Marcia P Jacob
- Heather Jarmon
All providers in Cullman, AL · Emergency Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.