NPIMap

Organization Active NPI

University of South Alabama Health Care Authority

Doing business as USA Health Dermatology

  • Dermatology Physician
  • Mobile, AL
National Provider Identifier
1255994141
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY
Doing business as
USA Health Dermatology
Practice address
4300 Old Shell Rd Ste B
Mobile, AL 36608-2036
Phone
(251) 342-7880
Fax
(251) 342-8369
NPI assigned
Apr 17, 2019
Last updated
Apr 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Authorized official

Name
Erica Madison
Title
Credentialing
Phone
(251) 318-2681

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4300 Old Shell Rd Ste B
Mobile, AL 36608-2036

Mailing address

3929-1 Airport Blvd
5TH Floor, Room 513
Mobile, AL 36609
Phone (251) 318-2681

Other names 1

  • USA Health Dermatology Doing business as

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
01D0305690USA Health Care Authority- USA Health Dermatology4300 Old Shell Rd Ste B, Mobile, AL 36608Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
University of South Alab18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

4300 Old Shell Rd
Ste B
Mobile, AL 36608
Phone (251) 342-7880

Practitioners & affiliated clinicians

Practitioners 3

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": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1255994141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929-1 AIRPORT BLVD",
            "address_2": "5TH FLOOR, ROOM 513",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36609",
            "telephone_number": "251-318-2681",
            "fax_number": "251-378-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 OLD SHELL RD STE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366082036",
            "telephone_number": "251-342-7880",
            "fax_number": "251-342-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2021-04-07",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "251-318-2681"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USA Health Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "USA Health Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.