Individual provider Active NPI

Jonathan Mahram, D.O.

  • Obstetrics & Gynecology Physician
  • Auburn, AL
National Provider Identifier
1366978306
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DO2573 Issued in AL
Practice address
2375 Champions Blvd
Auburn, AL 36830-6471
Phone
(334) 745-6447
Fax
(334) 742-0713
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DO2573 AL Primary

Addresses

Primary practice location

2375 Champions Blvd
Auburn, AL 36830-6471

Mailing address

2375 Champions Blvd
Auburn, AL 36830-6471
Phone (334) 745-6447

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210707003051 AL Practitioner - Obstetrics/Gynecology 3274807052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Obstetrics and Gynecology, PCGroup PAC ID 4880614270, 8 clinicians

Practice addresses (Care Compare)

2375 Champions Blvd
Auburn, AL 36830-6471
Phone (334) 745-6447

Hospital & facility affiliations

  • The East Alabama Healthcare Authority Hospital, Opelika, AL, CCN 010029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO2573ALMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Obstetrics & Gynecology, PC CurrentSince Aug 2, 2021 Accepting new patients
Sam del Toro LLC PastSince Dec 10, 2023 Accepting new patients
The East Alabama Health Care Authority Past Accepting new patients

Locations

2375 Champions Blvd
Auburn, AL 36830
Phone (334) 745-6447

2375 Champions Blvd
Ste 2
Auburn, AL 36830
Phone (334) 745-6447

121 N 20th St
Ste 2
Opelika, AL 36801
Phone (334) 528-2404

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1366978306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 CHAMPIONS BLVD",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368306471",
            "telephone_number": "334-745-6447",
            "fax_number": "334-742-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 CHAMPIONS BLVD",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368306471",
            "telephone_number": "334-745-6447",
            "fax_number": "334-742-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHRAM",
        "first_name": "JONATHAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "DO2573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

Verify at the official NPI Registry.