NPIMap

Organization Active NPI

University of Alabama at Birmingham

Doing business as UAB Health Center Montgomery

  • Internal Medicine Physician
  • Montgomery, AL
National Provider Identifier
1184738478
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UNIVERSITY OF ALABAMA AT BIRMINGHAM
Doing business as
UAB Health Center Montgomery
Practice address
2055 E South Blvd
Suite 202
Montgomery, AL 36116-2002
Phone
(334) 284-5211
Fax
(334) 284-9020
NPI assigned
Aug 17, 2006
Last updated
Jul 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Jeff Denney
Title
Administrator
Phone
(205) 229-0178

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Infectious Disease Physician 207RI0200X
Psychiatry Physician 2084P0800X
Hospitalist Physician 208M00000X

Addresses

Primary practice location

2055 E South Blvd
Suite 202
Montgomery, AL 36116-2002

Mailing address

2055 E South Blvd
Suite 202
Montgomery, AL 36116-2002
Phone (334) 284-5211

Other identifiers 2

IdentifierTypeStateIssuer
528301030MedicaidAL
Q991OtherALBCBS

Other names 1

  • UAB Health Center Montgomery Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.uab.edu University of Alabama at Birmingham

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000323 AL Part B Supplier - Clinic/Group Practice 3779487970 Receives reassigned benefits from 457 practitioners
11 other NPIs on this enrollment
Practice locations: Birmingham, AL; Selma, AL; Montgomery, AL

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 11

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0304302Uab Internal Med Health Ctr Montgomery2055 E South Blvd, Suite 202, Montgomery, AL 36116Certificate of waiverNov 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
OB GYN Research Diagnos48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

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

View all 47

Locations

2055 E South Blvd
Ste 202
Montgomery, AL 36116
Phone (205) 366-1605

Practitioners & affiliated clinicians

Practitioners 470

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 470

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1184738478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD",
            "address_2": "SUITE 202",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162002",
            "telephone_number": "334-284-5211",
            "fax_number": "334-284-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD",
            "address_2": "SUITE 202",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162002",
            "telephone_number": "334-284-5211",
            "fax_number": "334-284-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ALABAMA AT BIRMINGHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "DENNEY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "205-229-0178"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528301030",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Q991",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.uab.edu",
            "affiliation": "Y",
            "endpointDescription": "Company website",
            "affiliationName": "University of Alabama at Birmingham",
            "address_1": "1023 Medical Center Pkwy",
            "address_2": "Suite 200",
            "city": "Selma",
            "state": "AL",
            "country_code": "US",
            "postal_code": "367016780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UAB Health Center Montgomery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UAB Health Center Montgomery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.