Organization Active NPI

Allergy & Asthma Ctr of Tuscaloosa, PC

  • Allergy & Immunology Physician
  • Tuscaloosa, AL
National Provider Identifier
1215076088
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
ALLERGY & ASTHMA CTR OF TUSCALOOSA, PC
Practice address
535 Jack Warner Pkwy NE
Suite C
Tuscaloosa, AL 35404-5751
Phone
(205) 553-2252
Fax
(205) 553-3326
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Authorized official

Name
Mr. Bruce Bush
Title
Billing Manager
Phone
(800) 543-6869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X AL Primary

Addresses

Primary practice location

535 Jack Warner Pkwy NE
Suite C
Tuscaloosa, AL 35404-5751

Mailing address

535 Jack Warner Pkwy NE
Suite C
Tuscaloosa, AL 35404-5751
Phone (205) 553-2252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051222000025 AL Part B Supplier - Clinic/Group Practice 4587686290 Receives reassigned benefits from 3 practitioners
Practice locations: Tuscaloosa, AL

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
01D2264625Allergy and Asthma Center of Tuscaloosa, PC535 Jack Warner PKW, NE Suite C, Tuscaloosa, AL 35404Certificate of waiverJul 17, 2026

National Provider Directory

National Provider Directory

Locations

535 Jack Warner Pkwy NE
Ste C
Tuscaloosa, AL 35404
Phone (205) 553-2252

Practitioners & affiliated clinicians

Practitioners 4

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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1215076088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 JACK WARNER PKWY NE",
            "address_2": "SUITE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045751",
            "telephone_number": "205-553-2252",
            "fax_number": "205-553-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 JACK WARNER PKWY NE",
            "address_2": "SUITE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045751",
            "telephone_number": "205-553-2252",
            "fax_number": "205-553-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY & ASTHMA CTR OF TUSCALOOSA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "800-543-6869",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.