NPIMap

Organization Active NPI

Southern Alabama Physicians LLP

  • Emergency Medicine Physician
  • Dothan, AL
National Provider Identifier
1467701490
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOUTHERN ALABAMA PHYSICIANS LLP
Practice address
4370 W Main St
Dothan, AL 36305-1056
Phone
(337) 609-1382
Fax
(334) 793-4613
NPI assigned
Sep 6, 2012
Last updated
Nov 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Authorized official

Name
Dr. Derik K King, MD
Title
LLP Managing Partner
Phone
(800) 893-9698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

4370 W Main St
Dothan, AL 36305-1056

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (337) 609-1382

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121003000896 AL Part B Supplier - Clinic/Group Practice 0345499562 Receives reassigned benefits from 116 practitioners
1 other NPI on this enrollment
Practice locations: Enterprise, AL

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 118

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 118

NPI Registry JSON

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511740800000",
    "number": "1467701490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "337-609-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051056",
            "telephone_number": "337-609-1382",
            "fax_number": "334-793-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ALABAMA PHYSICIANS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-06",
        "last_updated": "2017-11-27",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DERIK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "LLP MANAGING PARTNER",
        "authorized_official_telephone_number": "800-893-9698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.