NPIMap

Organization Active NPI

Pulmonary Associates of the Southeast PC

  • Pulmonary Disease Physician
  • Birmingham, AL
National Provider Identifier
1306867676
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONARY ASSOCIATES OF THE SOUTHEAST PC
Practice address
3686 Grandview Pkwy
Suite 500
Birmingham, AL 35243-3407
Phone
(205) 802-2000
Fax
(205) 802-2012
NPI assigned
Jul 22, 2006
Last updated
Feb 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Authorized official

Name
Debi Waldrup, CMPE
Title
Administrator
Phone
(205) 802-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

3686 Grandview Pkwy
Suite 500
Birmingham, AL 35243-3407

Mailing address

3686 Grandview Pkwy
Suite 2500
Birmingham, AL 35243-3407
Phone (205) 802-2000

Other identifiers 1

IdentifierTypeStateIssuer
528302380MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040629000630 AL Part B Supplier - Clinic/Group Practice 4486630415 Receives reassigned benefits from 17 practitioners
Practice locations: Hoover, AL; Birmingham, AL

National Provider Directory

National Provider Directory

Locations

3686 Grandview Pkwy
Ste 2500
Birmingham, AL 35243

40 Inverness Center Pkwy
Ste 200
Hoover, AL 35242
Phone (205) 802-2000

3918 Montclair Rd
Ste 200
Mountain Brk, AL 35213
Phone (205) 802-2000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20095/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1306867676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3686 GRANDVIEW PKWY",
            "address_2": "SUITE 2500",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433407",
            "telephone_number": "205-802-2000",
            "fax_number": "205-802-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3686 GRANDVIEW PKWY",
            "address_2": "SUITE 500",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433407",
            "telephone_number": "205-802-2000",
            "fax_number": "205-802-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY ASSOCIATES OF THE SOUTHEAST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "WALDRUP",
        "authorized_official_first_name": "DEBI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "205-802-2000",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528302380",
            "state": "AL"
        }
    ],
    "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 Feb 29, 2016; 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.