NPIMap

Organization Active NPI

Oral & Facial Surgery of Al, PC

  • Specialist
  • Birmingham, AL
National Provider Identifier
1245340892
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ORAL & FACIAL SURGERY OF AL, PC
Practice address
1500 19TH St S
Suite 200
Birmingham, AL 35205-5628
Phone
(205) 933-2773
Fax
(205) 933-5147
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Lisa E Brown
Title
Office Manager
Phone
(205) 933-2773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X AL Primary

Addresses

Primary practice location

1500 19TH St S
Suite 200
Birmingham, AL 35205-5628

Mailing address

1500 19TH St S
Suite 200
Birmingham, AL 35205-5628
Phone (205) 933-2773

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051101000012 AL Part B Supplier - Clinic/Group Practice 3870510654 Receives reassigned benefits from 3 practitioners
Practice locations: Gardendale, AL; Trussville, AL; Birmingham, AL; Alexander City, AL

National Provider Directory

National Provider Directory

Locations

125 Alison Dr
Ste 3
Alexander City, AL 35010
Phone (205) 329-8459

1500 19th St S
#200
Birmingham, AL 35205
Phone (205) 930-9039

101 Payne Rd
Gardendale, AL 35071
Phone (205) 631-6834

151 N Chalkville Rd
Trussville, AL 35173
Phone (205) 655-9002

Practitioners & affiliated clinicians

Practitioners 9

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245340892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 19TH ST S",
            "address_2": "SUITE 200",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352055628",
            "telephone_number": "205-933-2773",
            "fax_number": "205-933-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 19TH ST S",
            "address_2": "SUITE 200",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352055628",
            "telephone_number": "205-933-2773",
            "fax_number": "205-933-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL & FACIAL SURGERY OF AL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "205-933-2773",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.