Organization Active NPI

Pediatric Radiology Associates PC

  • Pediatric Radiology Physician
  • Birmingham, AL
National Provider Identifier
1144268145
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
Legal business name
PEDIATRIC RADIOLOGY ASSOCIATES PC
Practice address
1600 7TH Ave S
Acc Ste 306
Birmingham, AL 35233-1711
Phone
(205) 939-9336
Fax
(205) 939-6872
NPI assigned
Jun 2, 2006
Last updated
Mar 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Larry S Simma
Title
Business Manager Cfo
Phone
(205) 871-4274

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X NU Primary

Addresses

Primary practice location

1600 7TH Ave S
Acc Ste 306
Birmingham, AL 35233-1711

Mailing address

2000A Southbridge Pkwy
Ste 300
Birmingham, AL 35209-7704
Phone (205) 871-4274

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040514000295 AL Part B Supplier - Clinic/Group Practice 1456341205 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Birmingham, AL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1600 7th Ave S
Ste 306
Birmingham, AL 35233
Phone (205) 939-9336

1940 Elmer J Bissell Rd
Ste B
Birmingham, AL 35243
Phone (205) 638-4938

2211 7th Ave S
Birmingham, AL 35233

1141 Payton Way
Leeds, AL 35094
Phone (205) 699-0729

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1144268145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000A SOUTHBRIDGE PKWY",
            "address_2": "STE 300",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352097704",
            "telephone_number": "205-871-4274",
            "fax_number": "205-871-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "address_2": "ACC STE 306",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-939-9336",
            "fax_number": "205-939-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC RADIOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "SIMMA",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BUSINESS MANAGER CFO",
        "authorized_official_telephone_number": "205-871-4274"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.