Organization Active NPI

University of South Alabama Health Care Authority

  • Internal Medicine Physician
  • Semmes, AL
National Provider Identifier
1306486253
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY
Practice address
7885 Moffett Rd
Semmes, AL 36575-5487
Phone
(251) 660-5840
Fax
(251) 660-5841
NPI assigned
Jan 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

7885 Moffett Rd
Semmes, AL 36575-5487

Mailing address

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

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

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1306486253",
    "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": "7885 MOFFETT RD",
            "city": "SEMMES",
            "state": "AL",
            "postal_code": "365755487",
            "telephone_number": "251-660-5840",
            "fax_number": "251-660-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-08",
        "last_updated": "2021-04-06",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Semmes, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.