Northeast Alabama Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

AL13699 Issued in AL

Legal business name

NORTHEAST ALABAMA DERMATOLOGY LLC

Practice address

201 Sivley Rd SW Ste 410
Huntsville, AL 35801-5146

Phone

(256) 536-3738

Fax

(256) 536-3737

NPI assigned

Jul 9, 2018

Organization subpart

No

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

Authorized official

Name

Melinda Birchmore Musick, MDNPI 1518912294

Title

Ceo

Phone

(256) 536-3738

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melinda Birchmore Musick, MD

  • Dermatology Physician
  • Huntsville, AL
  • NPI 1518912294
  Medicare reassignment Care Compare group NPD Authorized official
• Timothy Ryan Morgan, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
  • NPI 1760071344
  Medicare reassignment Care Compare group NPD
• Amber Harrison, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
  • NPI 1114343639
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531094400000",
    "number": "1174019541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SIVLEY RD SW STE 410",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015146",
            "telephone_number": "256-536-3738",
            "fax_number": "256-536-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SIVLEY RD SW STE 410",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015146",
            "telephone_number": "256-536-3738",
            "fax_number": "256-536-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ALABAMA DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-09",
        "last_updated": "2018-07-09",
        "status": "A",
        "authorized_official_last_name": "MUSICK",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "BIRCHMORE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-536-3738",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "AL13699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; 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.