Organization Active NPI

South Alabama Pediatrics

  • Pediatrics Physician
  • Opp, AL
National Provider Identifier
1366567190
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
108 Issued in AL
Legal business name
SOUTH ALABAMA PEDIATRICS
Practice address
101 E Paulk Ave
Opp, AL 36467-1727
Phone
(334) 493-2400
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Tammy Adams
Title
Office Manager
Phone
(334) 493-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 108 AL Primary

Addresses

Primary practice location

101 E Paulk Ave
Opp, AL 36467-1727

Mailing address

101 E Paulk Ave
Opp, AL 36467-1727

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
01D0999566South Alabama Pediatrics PC101 East Paulk Avenue, Opp, AL 36467Certificate of waiverMay 15, 2028

National Provider Directory

National Provider Directory

Locations

101 E Paulk Ave
Opp, AL 36467
Phone (334) 493-2400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366567190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E PAULK AVE",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364671727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E PAULK AVE",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364671727",
            "telephone_number": "334-493-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ALABAMA PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-493-2400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opp, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.