NPIMap

Organization Active NPI

Physician Medical Center, LLC

  • Family Medicine Physician
  • Birmingham, AL
National Provider Identifier
1114119567
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHYSICIAN MEDICAL CENTER, LLC
Doing business as
Physicians Medical Center Carraway
Practice address
1600 Carraway Blvd
Birmingham, AL 35234
Phone
(205) 502-5610
Fax
(205) 502-5513
NPI assigned
Aug 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Authorized official

Name
Mrs. Jan Dicesare
Title
Cfo
Phone
(205) 502-6111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1600 Carraway Blvd
Birmingham, AL 35234

Mailing address

PO Box 10288
Birmingham, AL 35202-0288
Phone (205) 502-5610

Other names 1

  • Physicians Medical Center Carraway Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Physician Medical Center LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1114119567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10288",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352020288",
            "telephone_number": "205-502-5610",
            "fax_number": "205-502-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CARRAWAY BLVD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35234",
            "telephone_number": "205-502-5610",
            "fax_number": "205-502-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "DICESARE",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-502-6111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Medical Center Carraway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; 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.