NPIMap

Organization Active NPI

Southern Medical Group, Inc

  • Emergency Medicine Physician
  • Birmingham, AL
National Provider Identifier
1194736009
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
152834 Issued in AL
Legal business name
SOUTHERN MEDICAL GROUP, INC
Practice address
1200 Corporate Dr
Suite 230
Birmingham, AL 35242-2941
Phone
(205) 995-7980
Fax
(205) 995-7985
NPI assigned
Aug 10, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Ms. Clarice D Kennedy
Title
Provider Enrollment Specialist
Phone
(205) 995-7980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 152834 AL Primary

Addresses

Primary practice location

1200 Corporate Dr
Suite 230
Birmingham, AL 35242-2941

Mailing address

1200 Corporate Dr
Suite 230
Birmingham, AL 35242-2941
Phone (205) 995-7980

National Provider Directory

National Provider Directory

Locations

4810 Bell Hill Rd
Bessemer, AL 35022
Phone (205) 426-3737

1801 1st Ave S
Ste 400
Birmingham, AL 35233

651 Beacon Pkwy W
Ste 208
Birmingham, AL 35209

200 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-3150

3500 Blue Lake Dr
Ste 480
Vestavia, AL 35243

Practitioners & affiliated clinicians

Practitioners 175

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 175

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1194736009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR",
            "address_2": "SUITE 230",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422941",
            "telephone_number": "205-995-7980",
            "fax_number": "205-995-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR",
            "address_2": "SUITE 230",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422941",
            "telephone_number": "205-995-7980",
            "fax_number": "205-995-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "CLARICE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "205-995-7980",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "152834",
            "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 Apr 20, 2008; 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.