Organization Active NPI

University of South Alabama Health Care Authority

  • Specialist
  • Mobile, AL
National Provider Identifier
1174005102
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY
Practice address
3290 Dauphin St
Mobile, AL 36606-4062
Phone
(251) 633-8880
NPI assigned
Sep 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
Erica Madison
Title
Credentialing
Phone
(251) 318-2681

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3290 Dauphin St
Mobile, AL 36606-4062

Mailing address

3929-1 Airport Blvd
5TH Floor, Room 513
Mobile, AL 36606
Phone (251) 318-2681

Other names 1

  • University Urology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
University of South Alab18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1174005102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929-1 AIRPORT BLVD",
            "address_2": "5TH FLOOR, ROOM 513",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36606",
            "telephone_number": "251-318-2681",
            "fax_number": "251-378-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064062",
            "telephone_number": "251-633-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "251-318-2681"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Urology",
            "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 Apr 29, 2021; 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.