NPIMap

Organization Active NPI

Pentastar, LLC

  • Family Medicine Physician
  • Cullman, AL
National Provider Identifier
1235365255
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7112 Issued in AL
Legal business name
PENTASTAR, LLC
Practice address
101 2ND Ave SE
Cullman, AL 35055-3511
Phone
(256) 737-1793
Fax
(256) 737-3765
NPI assigned
Jun 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Authorized official

Name
Dr. Gregory Lee Meiman, M.D.NPI 1932180270
Title
Physician/Director
Phone
(256) 737-1793

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 7112 AL Primary

Addresses

Primary practice location

101 2ND Ave SE
Cullman, AL 35055-3511

Mailing address

101 2ND Ave SE
Cullman, AL 35055-3511
Phone (256) 737-1793

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1235365255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 2ND AVE SE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350553511",
            "telephone_number": "256-737-1793",
            "fax_number": "256-737-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 2ND AVE SE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350553511",
            "telephone_number": "256-737-1793",
            "fax_number": "256-737-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENTASTAR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-04",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "MEIMAN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHYSICIAN/DIRECTOR",
        "authorized_official_telephone_number": "256-737-1793",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "7112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.