NPIMap

Organization Active NPI

Southern NP Associates, LLC

  • Adult Health Nurse Practitioner
  • Tuscaloosa, AL
National Provider Identifier
1407257447
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
SOUTHERN NP ASSOCIATES, LLC
Practice address
931 Fairfax Park
Tuscaloosa, AL 35406-2805
Phone
(205) 391-3600
NPI assigned
Sep 9, 2014
Last updated
Feb 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Authorized official

Name
Mr. Phillip Cody Long
Title
Vice President/Cfo
Phone
(205) 391-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X Primary

Addresses

Primary practice location

931 Fairfax Park
Tuscaloosa, AL 35406-2805

Mailing address

931 Fairfax Park
Tuscaloosa, AL 35406-2805
Phone (205) 391-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MO, FL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20150223000847 AL Part B Supplier - Clinic/Group Practice 1557686243 Receives reassigned benefits from 68 practitioners
Practice locations: Madison, AL; Mobile, AL; Moundville, AL; Northport, AL; Opp, AL; Ozark, AL; Pleasant Grove, AL; Prattville, AL…
O20161214001883 MO Part B Supplier - Clinic/Group Practice 1557686243 Receives reassigned benefits from 4 practitioners
Practice locations: Joplin, MO; Webb City, MO
O20170206002069 FL Part B Supplier - Clinic/Group Practice 1557686243 Receives reassigned benefits from 3 practitioners
Practice locations: Daytona Beach, FL; West Melbourne, FL

National Provider Directory

National Provider Directory

Locations

22969 Highway 25
Columbiana, AL 35051
Phone (205) 669-1712

5968 Wall Triana Hwy
Madison, AL 35757
Phone (256) 430-8417

931 Fairfax Park
Tuscaloosa, AL 35406
Phone (205) 343-7301

1505 E 4th Ave
York, AL 36925
Phone (205) 392-5281

Practitioners & affiliated clinicians

Practitioners 75

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 75

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1407257447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 FAIRFAX PARK",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062805",
            "telephone_number": "205-391-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 FAIRFAX PARK",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062805",
            "telephone_number": "205-391-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN NP ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "205-391-3600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.