Maryella D. Sirmon, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

04518 Issued in AL

Practice address

124A South University Blvd.
Mobile, AL 36608

Phone

(251) 343-5004

Fax

(251) 343-5136

NPI assigned

Dec 15, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1508842121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 850849",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366850849",
            "telephone_number": "251-343-5004",
            "fax_number": "251-343-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124A SOUTH UNIVERSITY BLVD.",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36608",
            "telephone_number": "251-343-5004",
            "fax_number": "251-343-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRMON",
        "first_name": "MARYELLA",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "04518",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "4518",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51060272",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000060272",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Mobile, AL
• Providers in Mobile, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; 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.