Southeastern Dermatology Centers

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHEASTERN DERMATOLOGY CENTERS

Practice address

817 Princeton Ave SW
Pob II, Suite 302
Birmingham, AL 35211-1333

Phone

(205) 781-6995

Fax

(205) 781-8783

NPI assigned

Apr 14, 2006

Organization subpart

Yes

Parent organization

BAPTIST HEALTH CENTERS, INC.As reported in NPPES

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

Authorized official

Name

G. Scott Fenn

Title

Chief Integration Officer

Phone

(205) 715-5415

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Baptist Health Centers LLC

Locations

Practitioners 1

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

• Elizabeth S. Martin, M.D.

  • Dermatology Physician
  • Hoover, AL
  • NPI 1942394689
  NPD (past)

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1194789172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13128",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352023128",
            "telephone_number": "205-715-5904",
            "fax_number": "205-715-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 PRINCETON AVE SW",
            "address_2": "POB II, SUITE 302",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111333",
            "telephone_number": "205-781-6995",
            "fax_number": "205-781-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN DERMATOLOGY CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST HEALTH CENTERS, INC.",
        "enumeration_date": "2006-04-14",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "FENN",
        "authorized_official_first_name": "G.",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CHIEF INTEGRATION OFFICER",
        "authorized_official_telephone_number": "205-715-5415"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529904550",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Rehab Medicine Inc
• Southeast Systemic Therapy and Consulting
• Southeaster Ocular Prosthetics
• Southeastern Brace, LLC
• Southeastern Bracing LLC
• Southeastern Diagnostic & Rehabilitation, LLC
• Southeastern Hospital Medicine LLC
• Southeastern Oncology Associates, PC
• Southern Anesthesia Services
• Southern Belle Group Inc

• Specialist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.