NPIMap

Organization Active NPI

Valley Pulmonary & Critical Care, P.C.

  • Pulmonary Disease Physician
  • Decatur, AL
National Provider Identifier
1205904752
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
22105 Issued in AL
Legal business name
VALLEY PULMONARY & CRITICAL CARE, P.C.
Practice address
1101 Somerville Rd SE
Decatur, AL 35601-3242
Phone
(256) 353-4665
Fax
(256) 353-8982
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Authorized official

Name
Mrs. Martha Boyle
Title
Practice Manager
Phone
(256) 353-4665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 22105 AL Primary

Addresses

Primary practice location

1101 Somerville Rd SE
Decatur, AL 35601-3242

Mailing address

1101 Somerville Rd SE
Decatur, AL 35601-3242
Phone (256) 353-4665

Other identifiers 3

IdentifierTypeStateIssuer
529804170MedicaidAL
510-79820OtherALBLUE CROSS& BLUE SHIELD
102G702006OtherALMEDICARE GROUP PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100927000827 AL Part B Supplier - Clinic/Group Practice 6901922020 Receives reassigned benefits from 2 practitioners
Practice locations: Decatur, AL

National Provider Directory

National Provider Directory

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1205904752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SOMERVILLE RD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013242",
            "telephone_number": "256-353-4665",
            "fax_number": "256-353-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SOMERVILLE RD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013242",
            "telephone_number": "256-353-4665",
            "fax_number": "256-353-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PULMONARY & CRITICAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "256-353-4665",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AL",
            "license": "22105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529804170",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS& BLUE SHIELD",
            "identifier": "510-79820",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "102G702006",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.