Individual provider Active NPI

Paul D Lavender, M.D.

  • Family Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1306945712
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24754 Issued in AL
Practice address
850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419
Phone
(205) 348-1770
Fax
(205) 348-1772
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24754 AL Primary

Addresses

Primary practice location

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419

Mailing address

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419
Phone (205) 348-1770

Other identifiers 1

IdentifierTypeStateIssuer
051555132MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000303 AL Practitioner - Family Practice 5698736031 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whatley Health Services IncGroup PAC ID 8224921705, 84 clinicians

Practice addresses (Care Compare)

2731 ML King Jr Blvd
Tuscaloosa, AL 35401-5235
Phone (205) 758-6647

809 University Blvd E
Tuscaloosa, AL 35401-7419
Phone (205) 348-1770

850 5TH Ave E
Tuscaloosa, AL 35401-7419
Phone (205) 348-1770

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457
Phone (205) 348-1770

Hospital & facility affiliations

  • Amedisys Home Health of Tuscaloosa Home health agency, Northport, AL, CCN 017300
  • DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy20
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24754ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Health Services Foundation PC Family Medicine CurrentSince Dec 1, 2013 Accepting new patients
Capstone Health Services Foundation PC CurrentSince Dec 1, 2013 Accepting new patients
The DCH Healthcare Authority CurrentSince Jan 19, 2025 Accepting new patients
The DCH Health Care Authority CurrentSince Jan 19, 2025 Accepting new patients

Locations

241 Robert K Wilson Dr
Carrollton, AL 35447
Phone (205) 367-2408

208 Pierson Ave
Centreville, AL 35042
Phone (205) 926-3230

6205 Jemison Ln
Northport, AL 35476
Phone (205) 348-6122

2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500

850 Peter Bryce Blvd
Tuscaloosa, AL 35401

700 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 348-7131

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

Interoperability endpoints

  • Direct secure messaging: pdrake.lavender.p1@direct.umc.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306945712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017419",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017419",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "PAUL",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "24754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051555132",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.