NPIMap

Organization Active NPI

Sobera Dermatology Group, PC

  • Dermatology Physician
  • Mountain BRK, AL
National Provider Identifier
1548437973
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
24170 Issued in AL
Legal business name
SOBERA DERMATOLOGY GROUP, PC
Practice address
2900 Cahaba Rd
Mountain BRK, AL 35223-1937
Phone
(205) 877-9773
NPI assigned
May 14, 2008
Last updated
Jan 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Jenny Sobera, MDNPI 1063460343
Title
President
Phone
(205) 877-9773

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
Dermatology Physician 207N00000X 24170 AL Primary

Addresses

Primary practice location

2900 Cahaba Rd
Mountain BRK, AL 35223-1937

Mailing address

2900 Cahaba Rd
Mountain BRK, AL 35223-1937
Phone (205) 877-9773

National Provider Directory

National Provider Directory

Locations

2900 Cahaba Rd
Mountain Brk, AL 35223
Phone (205) 572-4901

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": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1548437973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CAHABA RD",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352231937",
            "telephone_number": "205-877-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CAHABA RD",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352231937",
            "telephone_number": "205-877-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBERA DERMATOLOGY GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "SOBERA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-877-9773",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "24170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain BRK, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.