Organization Active NPI

Mobile Vascular Labs LLC

  • Nephrology Physician
  • Mobile, AL
National Provider Identifier
1124354501
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MOBILE VASCULAR LABS LLC
Practice address
1551 Old Shell Rd
Mobile, AL 36604-1354
Phone
(251) 433-1180
Fax
(251) 433-1181
NPI assigned
Oct 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Dr. Gregg Miller, MD
Title
Authorized Official
Phone
(717) 515-4048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1551 Old Shell Rd
Mobile, AL 36604-1354

Mailing address

PO Box 410207
Boston, MA 02241-0207
Phone (610) 644-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100107000169 AL Part B Supplier - Clinic/Group Practice 0143361519 Receives reassigned benefits from 4 practitioners
Practice locations: Mobile, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2152563Mobile Vascular Labs LLC1551 Old Shell Road, Mobile, AL 36604Certificate of waiverAug 12, 2026

National Provider Directory

National Provider Directory

Locations

124 S University Blvd
Ste A
Mobile, AL 36608
Phone (251) 342-5053

1551 Old Shell Rd
Mobile, AL 36604
Phone (251) 410-8272

Practitioners & affiliated clinicians

Practitioners 5

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": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1124354501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 410207",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022410207",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 OLD SHELL RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041354",
            "telephone_number": "251-433-1180",
            "fax_number": "251-433-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE VASCULAR LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "717-515-4048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.