NPIMap

Organization Active NPI

Eastern Hospital Medicine PC

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1104859123
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EASTERN HOSPITAL MEDICINE PC
Practice address
50 Medical Park East Dr
Birmingham, AL 35235
Phone
(205) 838-3000
Fax
(205) 874-8333
NPI assigned
Jul 10, 2006
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Lee T Wimberly, MDNPI 1033142054
Title
Owner
Phone
(205) 874-8306

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

50 Medical Park East Dr
Birmingham, AL 35235

Mailing address

PO Box 830674
MSC#716
Birmingham, AL 35283-0674
Phone (205) 874-8300

Other identifiers 2

IdentifierTypeStateIssuer
529930180MedicaidAL
DF1683OtherMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061011000241 AL Part B Supplier - Clinic/Group Practice 8325044597 Receives reassigned benefits from 67 practitioners
Practice locations: Hoover, AL; Vestavia, AL; Trussville, AL; Irondale, AL; Huntsville, AL; Cullman, AL; Birmingham, AL; Birmignham, AL…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hanceville Nursing & Rehab Center Inc.Hanceville, AL, CCN 015073 Skilled nursing facility Adp of the SNF Mar 5, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 70

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.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1104859123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830674",
            "address_2": "MSC#716",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352830674",
            "telephone_number": "205-874-8300",
            "fax_number": "205-874-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEDICAL PARK EAST DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35235",
            "telephone_number": "205-838-3000",
            "fax_number": "205-874-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN HOSPITAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "WIMBERLY",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-874-8306",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529930180",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DF1683",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.