Organization Active NPI

G. Perrin Underwood, M.D. P.C.

  • Ophthalmology Physician
  • Montgomery, AL
National Provider Identifier
1174759351
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
11798 Issued in AL
Legal business name
G. PERRIN UNDERWOOD, M.D. P.C.
Practice address
2055 Normandie Dr
Suite 212
Montgomery, AL 36111-2732
Phone
(334) 284-4106
Fax
(334) 284-4486
NPI assigned
Jun 2, 2009
Last updated
Jun 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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

Authorized official

Name
Dr. G Perrin Underwood, M.D.NPI 1780769927
Title
President
Phone
(334) 284-4106

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 11798 AL Primary

Addresses

Primary practice location

2055 Normandie Dr
Suite 212
Montgomery, AL 36111-2732

Mailing address

2055 Normandie Dr
Suite 212
Montgomery, AL 36111-2732
Phone (334) 284-4106

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090618000590 AL Part B Supplier - Clinic/Group Practice 7517017205 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Locations

2055 Normandie Dr
Ste 212
Montgomery, AL 36111
Phone (334) 284-4106

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/12a1c355-c61a-45a8-a04e-bf576ee7490b/

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245369600000",
    "number": "1174759351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 NORMANDIE DR",
            "address_2": "SUITE 212",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112732",
            "telephone_number": "334-284-4106",
            "fax_number": "334-284-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 NORMANDIE DR",
            "address_2": "SUITE 212",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112732",
            "telephone_number": "334-284-4106",
            "fax_number": "334-284-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G. PERRIN UNDERWOOD, M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-19",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "G PERRIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-284-4106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AL",
            "license": "11798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; 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.