Medical Associates of East Al, PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

DO222 Issued in AL

Legal business name

MEDICAL ASSOCIATES OF EAST AL, PC

Practice address

209 Fob James Dr
Valley, AL 36854-5079

Phone

(334) 756-6936

Fax

(334) 756-6937

NPI assigned

Aug 20, 2006

Last updated

Dec 5, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ivan Lewis Slavich III, D.O.NPI 1669587960

Title

President

Phone

(334) 756-6936

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 4

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.

• Ivan Lewis Slavich III, D.O.

  • Cardiovascular Disease Physician
  • Auburn, AL
  • NPI 1669587960
  Medicare reassignment NPD Authorized official
• William Ross Davis, MD

  • Cardiovascular Disease Physician
  • Alexander City, AL
  • NPI 1790716165
  NPD (past)
• Russell D Peterson, D.O.

  • Family Medicine Physician
  • Roanoke, AL
  • NPI 1144322504
  NPD (past)
• Rajesh Gulati, MD

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1013967108
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543968000000",
    "number": "1376658476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 FOB JAMES DR",
            "city": "VALLEY",
            "state": "AL",
            "postal_code": "368545079",
            "telephone_number": "334-756-6936",
            "fax_number": "334-756-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 FOB JAMES DR",
            "city": "VALLEY",
            "state": "AL",
            "postal_code": "368545079",
            "telephone_number": "334-756-6936",
            "fax_number": "334-756-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF EAST AL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-12-05",
        "status": "A",
        "authorized_official_last_name": "SLAVICH",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-756-6936",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "DO222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000033687",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000034036",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valalena L Maddox
• Krishnaveni Manku
• Nancy E Martin, RPH
• Patrick L Martin, M.D.
• Jennifer L McClendon, D.M.D.
• Rao R Meka, M.D.
• Melissa Ann Melton, MCD,CCC-SLP
• Michael Alan Grossman MD PC
• Gary Russell Mills, CRNA
• Miriam Valles MD PC

• Cardiovascular Disease Physician in Valley, AL
• Providers in Valley, AL by specialty
• Cardiovascular Disease Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.