Organization Active NPI

Gastrocare PC

  • Gastroenterology Physician
  • Tuscaloosa, AL
National Provider Identifier
1114039872
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROCARE PC
Practice address
100 Rice Mine Rd N Ste E
Tuscaloosa, AL 35406-2375
Phone
(205) 345-0010
Fax
(205) 986-0081
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Adisesha B Reddy, MDNPI 1407968167
Title
Provider/Owner
Phone
(205) 345-0010

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
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

100 Rice Mine Rd N Ste E
Tuscaloosa, AL 35406-2375

Mailing address

100 Rice Mine Rd N Ste E
Tuscaloosa, AL 35406-2375
Phone (205) 345-0010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611000282 AL Part B Supplier - Clinic/Group Practice 4981687712 Receives reassigned benefits from 3 practitioners
Practice locations: Tuscaloosa, AL

National Provider Directory

National Provider Directory

Locations

3400 Highway 78 E
Ste 404
Jasper, AL 35501
Phone (205) 221-7719

809 University Blvd E
Ste 3
Tuscaloosa, AL 35401

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114039872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RICE MINE RD N STE E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062375",
            "telephone_number": "205-345-0010",
            "fax_number": "205-986-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RICE MINE RD N STE E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062375",
            "telephone_number": "205-345-0010",
            "fax_number": "205-986-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "ADISESHA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "205-345-0010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.