NPIMap

Organization Active NPI

Birmingham AIDS Outreach

Doing business as Magic City Wellness Center

  • Primary Care Clinic/Center
  • Birmingham, AL
National Provider Identifier
1336507953
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
075108 Issued in AL
Legal business name
BIRMINGHAM AIDS OUTREACH
Doing business as
Magic City Wellness Center
Practice address
3220 5TH Ave S Ste 100
Birmingham, AL 35222-2309
Phone
(205) 877-8677
Fax
(205) 877-8675
NPI assigned
Feb 10, 2016
Last updated
Sep 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
Will Rainer
Title
Director
Phone
(205) 877-8677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 075108 AL Primary

Addresses

Primary practice location

3220 5TH Ave S Ste 100
Birmingham, AL 35222-2309

Mailing address

3220 5TH Ave S Ste 100
Birmingham, AL 35222-2309
Phone (205) 877-8677

Other names 1

  • Magic City Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181019000678 AL Part B Supplier - Clinic/Group Practice 6608129747 Receives reassigned benefits from 8 practitioners
Practice locations: Birmingham, AL

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
01D1039560Magic City Wellness Center3220 5TH Avenue South, Suite 100, Birmingham, AL 35222Provider-performed microscopyApr 17, 2027

National Provider Directory

National Provider Directory

Locations

3220 5th Ave S
Ste 100
Birmingham, AL 35222
Phone (205) 877-8677

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1336507953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 5TH AVE S STE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352222309",
            "telephone_number": "205-877-8677",
            "fax_number": "205-877-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 5TH AVE S STE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352222309",
            "telephone_number": "205-877-8677",
            "fax_number": "205-877-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIRMINGHAM AIDS OUTREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-10",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "RAINER",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "205-877-8677"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AL",
            "license": "075108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magic City Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.