Imc-Diagnostic and Medical Clinic LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

IMC-DIAGNOSTIC AND MEDICAL CLINIC LLC

Practice address

1700 Springhill Ave
Suite 100
Mobile, AL 36604-1407

Phone

(251) 435-1200

Fax

(251) 435-6357

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Cowart

Title

Vice President of Finance

Phone

(251) 435-1361

Specialties & licenses 14

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 219

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sam Abdehou, MD

  • Gastroenterology Physician
  • Mobile, AL
  • NPI 1134651656
  Medicare reassignment Care Compare group NPD
• Roger Martin Alvarado

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1265430243
  Medicare reassignment Care Compare group NPD
• Astra Autumn Amonett

  • Registered Nurse
  • Spanish Fort, AL
  • NPI 1275153298
  Medicare reassignment Care Compare group NPD
• Jerry Allan Banks Jr., M.D.

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1205179504
  Medicare reassignment Care Compare group NPD
• Nicholas Hugh Barlow

  • Family Nurse Practitioner
  • Mobile, AL
  • NPI 1124992227
  Medicare reassignment Care Compare group NPD
• Matthew Barnes

  • Family Nurse Practitioner
  • Mobile, AL
  • NPI 1912304031
  Medicare reassignment Care Compare group NPD
• Brandy Beckham, CRNP, ACNPC-AG, CCRN

  • Critical Care Medicine Nurse Practitioner
  • Mobile, AL
  • NPI 1851082150
  Medicare reassignment Care Compare group NPD
• Thaddeus Beeker, MD

  • Hematology & Oncology Physician
  • Mobile, AL
  • NPI 1780637579
  Medicare reassignment Care Compare group NPD
• Lauren Michelle Bender, CRNP

  • Acute Care Nurse Practitioner
  • Mobile, AL
  • NPI 1205535242
  Medicare reassignment Care Compare group NPD
• Haley Bohannon, CRNP

  • Acute Care Nurse Practitioner
  • Mobile, AL
  • NPI 1548968027
  Medicare reassignment Care Compare group NPD
• Gabriel Alejandro Bolanos Guzman, MD

  • Gastroenterology Physician
  • Mobile, AL
  • NPI 1114403292
  Medicare reassignment Care Compare group NPD
• Wilburn Donald Bolton III, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Mobile, AL
  • NPI 1225267289

  Internal Medicine

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1447201066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SPRING HILL AVE STE 100",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041416",
            "telephone_number": "251-435-1200",
            "fax_number": "251-435-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SPRINGHILL AVE",
            "address_2": "SUITE 100",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041407",
            "telephone_number": "251-435-1200",
            "fax_number": "251-435-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMC-DIAGNOSTIC AND MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "COWART",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "251-435-1361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.