Organization Active NPI

Red Mountain Psychiatry, L.L.C.

  • Psychiatry Physician
  • Birmingham, AL
National Provider Identifier
1508698473
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
RED MOUNTAIN PSYCHIATRY, L.L.C.
Practice address
3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone
(205) 937-3948
NPI assigned
Aug 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Edward Austin Tucker, CRNP
Title
Ceo
Phone
(205) 937-3948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3690 Grandview Pkwy
Birmingham, AL 35243-3326

Mailing address

7130 Sellers Rd
Dora, AL 35062-2409

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250814004832 AL Part B Supplier - Clinic/Group Practice 4284133547 Practice locations: Birmingham, AL; Gardendale, AL

National Provider Directory

National Provider Directory

Locations

313 Fieldstown Rd
Gardendale, AL 35071
Phone (205) 285-5115

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1508698473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7130 SELLERS RD",
            "city": "DORA",
            "state": "AL",
            "postal_code": "350622409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 GRANDVIEW PKWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433326",
            "telephone_number": "205-937-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED MOUNTAIN PSYCHIATRY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "205-937-3948",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "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 19, 2024; 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.