Organization Active NPI

Shoals Gastroenterology, LLC

  • Gastroenterology Physician
  • Florence, AL
National Provider Identifier
1417601196
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SHOALS GASTROENTEROLOGY, LLC
Practice address
3103 Florence Blvd
Florence, AL 35634-2546
Phone
(256) 444-4401
NPI assigned
Feb 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Gabriel Ionescu, MD
Title
President
Phone
(917) 991-7953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

3103 Florence Blvd
Florence, AL 35634-2546

Mailing address

3103 Florence Blvd
Florence, AL 35634-2546
Phone (256) 444-4401

Other practice location 1

22281 US Highway 72 Ste A
Athens, AL 35613-2601
Phone (256) 444-4401

National Provider Directory

National Provider Directory

Locations

3103 Florence Blvd
Florence, AL 35634
Phone (256) 444-4401

Practitioners & affiliated clinicians

Practitioners 1

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": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1417601196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 FLORENCE BLVD",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356342546",
            "telephone_number": "256-444-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 FLORENCE BLVD",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356342546",
            "telephone_number": "256-444-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22281 US Highway 72 Ste A",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "AL",
            "postal_code": "356132601",
            "country_code": "US",
            "telephone_number": "256-444-4401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHOALS GASTROENTEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "IONESCU",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-991-7953",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.