NPIMap

Organization Active NPI

Cooper Green Mercy Health Services Authority an Affiliate of Uab

  • Clinic/Center
  • Birmingham, AL
National Provider Identifier
1366073108
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COOPER GREEN MERCY HEALTH SERVICES AUTHORITY AN AFFILIATE OF UAB
Practice address
1509 6TH Ave S
Birmingham, AL 35233-1601
Phone
(205) 930-3200
NPI assigned
Jan 30, 2020
Last updated
Dec 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Steve Payne
Title
Cfo
Phone
(205) 930-3200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

1509 6TH Ave S
Birmingham, AL 35233-1601

Mailing address

1509 6TH Ave S
Birmingham, AL 35233-1601
Phone (205) 930-3200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200402003238 AL Part B Supplier - Clinic/Group Practice 0840629473 Receives reassigned benefits from 191 practitioners
Practice locations: Birmingham, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Cooper Green Mercy Health Services Authority an Affiliate of Uab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 198

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 198

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1366073108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331601",
            "telephone_number": "205-930-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331601",
            "telephone_number": "205-930-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER GREEN MERCY HEALTH SERVICES AUTHORITY AN AFFILIATE OF UAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-930-3200"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Dec 16, 2024; 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.