Individual provider Active NPI

Preeth Jayaram, M.D.

  • Family Medicine Physician
  • Mobile, AL
National Provider Identifier
1124559646
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
90513 Issued in GA
Practice address
2451 Fillingim St # St709
Mobile, AL 36617-2238
Phone
(251) 445-8282
Fax
(251) 445-8281
NPI assigned
Mar 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 90513 GA Primary

Addresses

Primary practice location

2451 Fillingim St # St709
Mobile, AL 36617-2238

Mailing address

2451 Fillingim St # St709
Mobile, AL 36617-2238
Phone (251) 445-8282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220617002389 GA Practitioner - Family Practice 2264787035 Reassigns benefits to 1 organization
I20231009001956 FL Practitioner - General Practice 2264787035 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
90513GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Physicians of Georgia Primary Care, PC Family Medicine CurrentSince Jun 13, 2022 Accepting new patients
American Current Care P.a. CurrentSince Oct 2, 2023 Accepting new patients
Afc Physicians of Georgia Primary Care, PC Family Medicine Current Accepting new patients
American Current Care PA CurrentSince Oct 2, 2023 Accepting new patients
American Current Care PA Current Accepting new patients
Afc Physicians of Georgia Urgent Care, PC Past Accepting new patients

Locations

3700 Cahaba Beach Rd
Hoover, AL 35242
Phone (205) 403-8902

1036 Dunn Ave
Ste 10
Jacksonville, FL 32218
Phone (904) 903-5520

7800 NW 25th St
Ste 4
Miami, FL 33122
Phone (305) 593-2174

4455 Medical Center Way
West Palm Beach, FL 33407
Phone (561) 881-0066

6509 Gateway Rd
Columbus, GA 31909
Phone (706) 243-0174

26 Parkway Dr
Ft Oglethorpe, GA 30742
Phone (706) 956-2846

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1124559646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 FILLINGIM ST # ST709",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172238",
            "telephone_number": "251-445-8282",
            "fax_number": "251-445-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 FILLINGIM ST # ST709",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172238",
            "telephone_number": "251-445-8282",
            "fax_number": "251-445-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYARAM",
        "first_name": "PREETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-26",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "90513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.