Individual provider Active NPI

Jon Erik Gam, CRNP

  • Acute Care Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1356856165
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-149059 Issued in AL
Practice address
1201 11TH Ave S
Birmingham, AL 35205-3423
Phone
(205) 934-3411
NPI assigned
Dec 4, 2017
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-149059 AL Primary

Addresses

Primary practice location

1201 11TH Ave S
Birmingham, AL 35205-3423

Mailing address

619 19TH St S # Jt804
Birmingham, AL 35249-6810
Phone (205) 934-4696

Other practice location 1

500 22nd St S
Birmingham, AL 35233-3110
Phone (205) 996-4314

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgam@direct.uabmedicine.org Direct University of Alabama Hospital

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180725003837 AL Practitioner - Nurse Practitioner 9133476864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-149059ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Feb 1, 2018 Accepting new patients
Signify Health, LLC CurrentSince Jun 10, 2021 Accepting new patients

Locations

1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

619 19th St S
#804
Birmingham, AL 35249
Phone (205) 934-6007

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: jgam@direct.uabmedicine.org

Organizations & group practices 2

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

Hospital & facility affiliations 2

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": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1356856165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 19TH ST S # JT804",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352496810",
            "telephone_number": "205-934-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053423",
            "telephone_number": "205-934-3411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 22nd St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352333110",
            "country_code": "US",
            "telephone_number": "205-996-4314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAM",
        "first_name": "JON",
        "middle_name": "ERIK",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-149059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgam@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 22nd St S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352333110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.