NPIMap

Organization Active NPI

Darrell S. Prestridge, DO, PC

  • Ophthalmology Physician
  • Pelham, AL
National Provider Identifier
1508817198
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
DARRELL S. PRESTRIDGE, DO, PC
Practice address
2122 Old Montgomery Hwy
Pelham, AL 35124-1138
Phone
(205) 621-3437
Fax
(205) 621-8550
NPI assigned
May 16, 2006
Last updated
Dec 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Authorized official

Name
Darrell S PrestridgeNPI 1376543801
Title
Owner
Phone
(205) 621-3437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

2122 Old Montgomery Hwy
Pelham, AL 35124-1138

Mailing address

PO Box 531326
Birmingham, AL 35253-1326
Phone (205) 621-3437

Other identifiers 2

IdentifierTypeStateIssuer
529927780MedicaidAL
DE6484OtherALRAILROAD MEDICARE GROUP #

National Provider Directory

National Provider Directory

Locations

840 Montclair Rd
Ste 722
Birmingham, AL 35213
Phone (205) 591-2311

1 Independence Sq
Ste 210
Butler, AL 36904
Phone (205) 459-4733

1912 Cherokee Ave SW
Ste 3600
Cullman, AL 35055
Phone (256) 736-1100

1401 US Highway 80 W
Demopolis, AL 36732
Phone (334) 289-0466

921 US Highway 80 E
Demopolis, AL 36732

1407 Memorial Pkwy NW
Huntsville, AL 35801

58 Vine St
Mountain Brk, AL 35213
Phone (205) 870-4205

801 Dallas Ave
Selma, AL 36701
Phone (334) 323-6361

Practitioners & affiliated clinicians

Practitioners 4

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": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1508817198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 531326",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352531326",
            "telephone_number": "205-621-3437",
            "fax_number": "205-621-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 OLD MONTGOMERY HWY",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351241138",
            "telephone_number": "205-621-3437",
            "fax_number": "205-621-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARRELL S. PRESTRIDGE, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "PRESTRIDGE",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-621-3437"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529927780",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "DE6484",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.