NPIMap

Organization Active NPI

Mobile Gastroenterology, PC

  • Gastroenterology Physician
  • Mobile, AL
National Provider Identifier
1124031141
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MOBILE GASTROENTEROLOGY, PC
Practice address
6701 Airport Blvd
Suite a-208
Mobile, AL 36608-6705
Phone
(251) 639-2101
Fax
(251) 639-9122
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Charles Edward Johnson, M.D.
Title
Physician and Ceo
Phone
(251) 639-2101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

6701 Airport Blvd
Suite a-208
Mobile, AL 36608-6705

Mailing address

PO Box 850489
Mobile, AL 36685-0489
Phone (251) 639-2101

Other identifiers 1

IdentifierTypeStateIssuer
I960OtherMEDICARE GROUP PROVIDER

National Provider Directory

National Provider Directory

Locations

6701 Airport Blvd
Ste A208
Mobile, AL 36608
Phone (205) 633-2262

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1124031141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850489",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366850489",
            "telephone_number": "251-639-2101",
            "fax_number": "251-639-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD",
            "address_2": "SUITE A-208",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086705",
            "telephone_number": "251-639-2101",
            "fax_number": "251-639-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE GASTROENTEROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN AND CEO",
        "authorized_official_telephone_number": "251-639-2101",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PROVIDER",
            "identifier": "I960",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 18, 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.