NPIMap

Organization Active NPI

University of South Alabama Health Services Foundation

  • Multi-Specialty Clinic/Center
  • Mobile, AL
National Provider Identifier
1467513341
Registry record updated Nov 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
UNIVERSITY OF SOUTH ALABAMA HEALTH SERVICES FOUNDATION
Practice address
575 Stanton Rd
Mobile, AL 36617-2344
Phone
(251) 471-7207
Fax
(251) 471-7468
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2013

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

Authorized official

Name
Becky S. Tate
Title
Chief Executive Officer
Phone
(251) 470-5842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

575 Stanton Rd
Mobile, AL 36617-2344

Mailing address

PO Box 40480
Mobile, AL 36640-0480
Phone (251) 470-5842

Other identifiers 2

IdentifierTypeStateIssuer
528500370MedicaidAL
09013348MedicaidMS

Other names 1

  • USA Stanton Road Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
University of South Alabama Health Services Foundation23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385510400000",
    "number": "1467513341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40480",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366400480",
            "telephone_number": "251-470-5842",
            "fax_number": "251-470-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 STANTON RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172344",
            "telephone_number": "251-471-7207",
            "fax_number": "251-471-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTH ALABAMA HEALTH SERVICES FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2013-11-27",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "251-470-5842"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528500370",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013348",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USA Stanton Road Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; 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.