NPIMap

Organization Active NPI

Tennessee Valley OB-GYN Clinic PC

  • Obstetrics & Gynecology Physician
  • Huntsville, AL
National Provider Identifier
1376678854
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
23915 Issued in AL
Legal business name
TENNESSEE VALLEY OB-GYN CLINIC PC
Practice address
910 Adams St SE Ste 200
Huntsville, AL 35801-3759
Phone
(256) 265-6512
Fax
(256) 265-6727
NPI assigned
Feb 23, 2007
Last updated
Apr 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Authorized official

Name
Sharon CallisonNPI 1013901107
Title
MD
Phone
(256) 265-6512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 23915 AL Primary

Addresses

Primary practice location

910 Adams St SE Ste 200
Huntsville, AL 35801-3759

Mailing address

910 Adams St Ste 200
Huntsville, AL 35801-3759
Phone (256) 265-6512

Other identifiers 1

IdentifierTypeStateIssuer
529910490MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414000758 AL Part B Supplier - Clinic/Group Practice 2264426949 Receives reassigned benefits from 1 practitioner
Practice locations: Huntsville, AL

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
01D0303017Tennessee Valley OB-GYN Clinic PC910 Adams Street SE Suite 200, Huntsville, AL 35801Provider-performed microscopyDec 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1376678854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 ADAMS ST STE 200",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013759",
            "telephone_number": "256-265-6512",
            "fax_number": "256-265-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 ADAMS ST SE STE 200",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013759",
            "telephone_number": "256-265-6512",
            "fax_number": "256-265-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE VALLEY OB-GYN CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "CALLISON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "256-265-6512"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "23915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529910490",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.