Organization Active NPI

Alabama Infectious Disease Center P.C.

  • Infectious Disease Physician
  • Huntsville, AL
National Provider Identifier
1215094446
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
31607 Issued in AL
Legal business name
ALABAMA INFECTIOUS DISEASE CENTER P.C.
Practice address
420 Lowell Dr
Suite 301
Huntsville, AL 35801-3762
Phone
(256) 265-7955
Fax
(256) 265-7954
NPI assigned
Jan 3, 2007
Last updated
Nov 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Authorized official

Name
Mrs. Kimberly Dawn Whisenant, NONE
Title
Office Manager
Phone
(256) 265-7955

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 25943 AL
Infectious Disease Physician 207RI0200X 28544 AL
Infectious Disease Physician 207RI0200X 31607 AL Primary

Addresses

Primary practice location

420 Lowell Dr
Suite 301
Huntsville, AL 35801-3762

Mailing address

420 Lowell Dr
Suite 301
Huntsville, AL 35801-3762
Phone (256) 265-7955

Other identifiers 3

IdentifierTypeStateIssuer
1447446935MedicaidAL
150458MedicaidAL
009970955MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041207000550 AL Part B Supplier - Clinic/Group Practice 2860458395 Receives reassigned benefits from 3 practitioners
Practice locations: Huntsville, 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
01D0993107Alabama Infectious Disease Center PC420 Lowell Drive Suite 301, Huntsville, AL 35801Certificate of waiverNov 4, 2027

National Provider Directory

National Provider Directory

Locations

420 Lowell Dr SE
Huntsville, AL 35801
Phone (256) 265-1910

420 Lowell Dr SE
Ste 301
Huntsville, AL 35801
Phone (256) 265-7955

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384300800000",
    "number": "1215094446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LOWELL DR",
            "address_2": "SUITE 301",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013762",
            "telephone_number": "256-265-7955",
            "fax_number": "256-265-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LOWELL DR",
            "address_2": "SUITE 301",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013762",
            "telephone_number": "256-265-7955",
            "fax_number": "256-265-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALABAMA INFECTIOUS DISEASE CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2013-11-13",
        "status": "A",
        "authorized_official_last_name": "WHISENANT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "256-265-7955",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NONE"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AL",
            "license": "25943",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AL",
            "license": "28544",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AL",
            "license": "31607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447446935",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150458",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009970955",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.