Organization Active NPI

Liberty Mountain Pediatrics, P.C.

  • Pediatrics Physician
  • Birmingham, AL
National Provider Identifier
1487133898
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LIBERTY MOUNTAIN PEDIATRICS, P.C.
Practice address
4600 Highway 280
Birmingham, AL 35242-5028
Phone
(205) 790-1650
NPI assigned
Aug 8, 2018
Last updated
Aug 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Authorized official

Name
Gregg William Thomas
Title
Administrator
Phone
(205) 709-1650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

4600 Highway 280
Birmingham, AL 35242-5028

Mailing address

4600 Highway 280
Birmingham, AL 35242-5028
Phone (205) 790-1650

National Provider Directory

National Provider Directory

Locations

4600 Highway 280
Ste 103
Birmingham, AL 35242

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533686400000",
    "number": "1487133898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 HIGHWAY 280",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425028",
            "telephone_number": "205-790-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 HIGHWAY 280",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425028",
            "telephone_number": "205-790-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY MOUNTAIN PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "205-709-1650"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 8, 2018; 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.