Individual provider Active NPI

Alexandra Averill Mattox, PA-C

  • Physician Assistant
  • Mobile, AL
National Provider Identifier
1457832875
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
101 Memorial Hospital Dr Ste 200
Mobile, AL 36608-1787
Phone
(251) 414-5900
Fax
(251) 281-1231
NPI assigned
Aug 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AL Primary

Addresses

Primary practice location

101 Memorial Hospital Dr Ste 200
Mobile, AL 36608-1787

Mailing address

101 Memorial Hospital Dr Ste 200
Mobile, AL 36608-1787
Phone (251) 414-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181010003047 AL Practitioner - Physician Assistant 5395097851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Alabama College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alabama Medical Group PCGroup PAC ID 6709152499, 42 clinicians

Practice addresses (Care Compare)

101 Memorial Hospital Dr
Suite 200
Mobile, AL 36608-1787
Phone (251) 414-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1396ALMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Center Current Accepting new patients

Locations

101 Memorial Hospital Dr
Ste 200
Mobile, AL 36608
Phone (251) 414-3079

Interoperability endpoints

  • Direct secure messaging: alexandraaverill@amgmd.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1457832875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MEMORIAL HOSPITAL DR STE 200",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081787",
            "telephone_number": "251-414-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEMORIAL HOSPITAL DR STE 200",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081787",
            "telephone_number": "251-414-5900",
            "fax_number": "251-281-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOX",
        "first_name": "ALEXANDRA",
        "middle_name": "AVERILL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.