Weiss Lake Hospitalists, LLC
Organization Active NPI Hospitalist Physician · Centre, AL
NPI 1205397643 · NPPES record last updated Feb 5, 2020
Key facts
- NPI
- 1205397643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospitalist Physician 208M00000X
- Legal business name
- WEISS LAKE HOSPITALISTS, LLC
- Practice address
- 400 Northwood Dr
Centre, AL 35960-1023 - Phone
- (256) 927-5531
- NPI assigned
- Mar 28, 2019
- Organization subpart
- No
Authorized official
- Name
- Kim H Larsen
- Title
- Director of Credentialing
- Phone
- (770) 874-5400
Practitioners 45
-
Emily Beth Oliver, CRNP
-
Patrick Jay Lynn, MD
-
Tasha Cobb Adkison, CRNP
-
Kenneth Elisha Conn, CRNP
-
Connie Leigh Geimer, ACNP
-
Radwan Mallah, MD
-
Eric Eugene Melancon, M.D.
-
Tony Arland White, M.D.
-
Robert H Williams, M.D.
-
Catherine K Dickens, M.D.
-
Sheba Dryer, NP-C
-
Alfonso Luis Espinel, M.D,
-
Kim Carlos Farmer, FNP
-
John Kevin Hardwell, M.D.
-
James O Hill II, DO
-
Brian A Horton, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190722002439 | AL | Part B Supplier - Clinic/Group Practice | 5799011219 |
Receives reassigned benefits from 44 practitioners Practice locations: Centre, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician |
208M00000X | Yes |
Addresses
Primary practice location
400 Northwood Dr
Centre, AL 35960-1023
Mailing address
PO Box 24962
Belfast, ME 04915-2000
Phone (770) 540-5400
Other providers in Centre, AL
- Wal-Mart Stores East LP
- Wal-Mart Stores East, LP
- James P Walker
- Madeline Ware
- Weiss Lake Counseling Services
- Weiss Lake Psychological Services, LLC
- Katelyn Wilson West
- Brooklyn Hammonds Whaley
- Laura Lee Wheeler
- Helen Elese Hope White
All providers in Centre, AL · Hospitalist Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.