South Alabama Diagnostic Imaging, P.C.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

10925 Issued in AL

Legal business name

SOUTH ALABAMA DIAGNOSTIC IMAGING, P.C.

Practice address

1200 W Maple Ave
Geneva, AL 36340-1642

Phone

(334) 684-7156

Fax

(334) 684-7709

NPI assigned

Dec 14, 2006

Last updated

Jun 14, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John C Tomberlin, M.D.NPI 1275511370

Title

Owner

Phone

(334) 684-7156

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL, GA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• South Alabama Diagnostic Imaging PC

  dba John C Tomberlin

  • Diagnostic Radiology Physician
  • Bonifay, FL
  • NPI 1437332947

  4688562994

  Same PAC ID

Tax ID family

John C Tomberlin3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• South Alabama Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Marianna, FL
  • NPI 1295008613
  NPD tax ID
• South Alabama Diagnostic Imaging PC

  dba John C Tomberlin

  • Diagnostic Radiology Physician
  • Bonifay, FL
  • NPI 1437332947
  NPD tax ID

Locations

Practitioners 3

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.

• John Carey Tomberlin, MD

  • Diagnostic Radiology Physician
  • Fort Rucker, AL
  • NPI 1275511370

  GA

  Medicare reassignment Authorized official
• Vicki Amanda Kelley, CRNP

  • Family Nurse Practitioner
  • Fort Rucker, AL
  • NPI 1093130791
  NPD (past)
• Christina Clem Smith, M.D.

  • Psychiatry Physician
  • Vestavia, AL
  • NPI 1568492007
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560470400000",
    "number": "1477615938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1928",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398181928",
            "telephone_number": "334-684-3655",
            "fax_number": "334-684-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W MAPLE AVE",
            "city": "GENEVA",
            "state": "AL",
            "postal_code": "363401642",
            "telephone_number": "334-684-7156",
            "fax_number": "334-684-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ALABAMA DIAGNOSTIC IMAGING, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2019-06-14",
        "status": "A",
        "authorized_official_last_name": "TOMBERLIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-684-7156",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "10925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDIA MEDICAID",
            "identifier": "047944600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000085322",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bobbi Houston Pippins, LICSW-S
• David Hyatt Pope, MD
• John Franklin Simmons, M.D
• John Franklin Simmons Jr., MD
• South Alabama Diagnostic Imaging (Omni MRI)
• Southeast Alabama Rural Health Associates
• Southeast Alabama Rural Health Associates (Geneva Family Health Center)
• Southern Family Practice,LLC
• State of Alabama
• State of Alabama Department of Public Health (Geneva County Health Dept Flu-Pneu)

• Diagnostic Radiology Physician in Geneva, AL
• Providers in Geneva, AL by specialty
• Diagnostic Radiology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.