NPIMap

Organization Active NPI

Jefferson County Board of Health

Doing business as Eastern Health Center

  • Public Health or Welfare Agency
  • Birmingham, AL
National Provider Identifier
1447285390
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
JEFFERSON COUNTY BOARD OF HEALTH
Doing business as
Eastern Health Center
Practice address
601 West Blvd
Birmingham, AL 35206-1300
Phone
(205) 591-5180
Fax
(205) 510-3476
NPI assigned
Jul 11, 2006
Last updated
Feb 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Authorized official

Name
Shewanda Clark
Title
Revenue Integrity Supervisor
Phone
(205) 558-2158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

601 West Blvd
Birmingham, AL 35206-1300

Mailing address

PO Box 2648
Birmingham, AL 35202-2648
Phone (205) 591-5180

Other identifiers 5

IdentifierTypeStateIssuer
227319999MedicaidAL
G588OtherALMEDICARE GROUP NUMBER
303710000MedicaidAL
51060507OtherALBLUE SHIELD
227310000MedicaidAL

Other names 1

  • Eastern Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040428001696 AL Part B Supplier - Clinic/Group Practice 1456348622 Receives reassigned benefits from 14 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Birmingham, AL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

601 West Blvd
Birmingham, AL 35206
Phone (205) 510-3406

586 Morris Majestic Rd
Morris, AL 35116
Phone (205) 647-0572

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1447285390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2648",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352022648",
            "telephone_number": "205-591-5180",
            "fax_number": "205-510-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WEST BLVD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352061300",
            "telephone_number": "205-591-5180",
            "fax_number": "205-510-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SHEWANDA",
        "authorized_official_title_or_position": "REVENUE INTEGRITY SUPERVISOR",
        "authorized_official_telephone_number": "205-558-2158"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227319999",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "G588",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303710000",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "51060507",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227310000",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastern Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.