NPIMap

Organization Active NPI

Southern Medical Group Inc

  • Emergency Medicine Physician
  • Jasper, AL
National Provider Identifier
1427268077
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOUTHERN MEDICAL GROUP INC
Practice address
3400 Highway 78 E
Jasper, AL 35501-8907
Phone
(205) 387-4187
Fax
(205) 387-4727
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Ms. Clarice D Kennedy
Title
Provider Enrollment Specialist
Phone
(205) 995-7980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

3400 Highway 78 E
Jasper, AL 35501-8907

Mailing address

1200 Corporate Dr
Suite 230
Birmingham, AL 35242-2941
Phone (205) 995-7980

National Provider Directory

National Provider Directory
Tax ID family
Southern Medical Group Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3400 Highway 78 E
Jasper, AL 35501
Phone (205) 387-4000

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1427268077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR",
            "address_2": "SUITE 230",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422941",
            "telephone_number": "205-995-7980",
            "fax_number": "205-995-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 HIGHWAY 78 E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018907",
            "telephone_number": "205-387-4187",
            "fax_number": "205-387-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "CLARICE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "205-995-7980",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.