Individual provider Active NPI

William Mitchell Parker, PA

  • Surgical Physician Assistant
  • Birmingham, AL
National Provider Identifier
1366506610
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA116 Issued in AL
Practice address
200 Montgomery Hwy
Suite 200
Birmingham, AL 35216-1842
Phone
(205) 822-9595
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA116 AL Primary

Addresses

Primary practice location

200 Montgomery Hwy
Suite 200
Birmingham, AL 35216-1842

Mailing address

200 Montgomery Hwy
Suite 200
Birmingham, AL 35216-1842
Phone (205) 822-9595

Other identifiers 1

IdentifierTypeStateIssuer
051525042MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA116ALMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brookwood Primary Care-Mountain Brook, L.L.C. Current Accepting new patients
Brookwood Sports and Orthopedics, L.L.C. Current Accepting new patients
Alabama Sports Medicine and Ortho Center Past Accepting new patients
Andrews Sports Medicine and Orthopaedic Center Past Accepting new patients

Locations

4500 Montevallo Rd
Ste E101
Irondale, AL 35210
Phone (205) 877-1889

200 Montgomery Hwy
Ste 200
Vestavia Hills, AL 35216
Phone (205) 822-9595

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366506610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MONTGOMERY HWY",
            "address_2": "SUITE 200",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352161842",
            "telephone_number": "205-822-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MONTGOMERY HWY",
            "address_2": "SUITE 200",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352161842",
            "telephone_number": "205-822-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "WILLIAM",
        "middle_name": "MITCHELL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051525042",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.