NPIMap

Organization Active NPI

University of South Alabama

  • Child Abuse Pediatrics Physician
  • Mobile, AL
National Provider Identifier
1114388667
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X
Legal business name
UNIVERSITY OF SOUTH ALABAMA
Practice address
1601 Center St Ste 1N
Mobile, AL 36604-1541
Phone
(251) 410-5437
Fax
(251) 434-3802
NPI assigned
Mar 11, 2016
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Glen Owen Bailey
Title
Ceo
Phone
(251) 471-7118

Corporate family (same tax ID) 17

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

National Provider Directory

National Provider Directory
Tax ID family
University of South Alabama Mitchell Cancer Institute (53 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Child Abuse Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080C0008X Primary

Addresses

NPPES NPI Registry

Primary practice location

1601 Center St Ste 1N
Mobile, AL 36604-1541

Mailing address

PO Box 40480
Mobile, AL 36640-0480
Phone (251) 434-3626

Other names 1

NPPES NPI Registry
  • USA Child Abuse Pediatrics Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114388667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40480",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366400480",
            "telephone_number": "251-434-3626",
            "fax_number": "251-445-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CENTER ST STE 1N",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041541",
            "telephone_number": "251-410-5437",
            "fax_number": "251-434-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTH ALABAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "OWEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "251-471-7118"
    },
    "taxonomies": [
        {
            "code": "2080C0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USA Child Abuse Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.