Individual provider Active NPI

Kathleen Quinn Wojtala, FNP-C

  • Family Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1568948990
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-179653 Issued in AL
Practice address
1700 Center St
Mobile, AL 36604-3301
Phone
(251) 415-1055
Fax
(251) 415-1045
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 24427 TN
Family Nurse Practitioner 363LF0000X 1-179653 AL Primary

Addresses

Primary practice location

1700 Center St
Mobile, AL 36604-3301

Mailing address

PO Box 40480
Mobile, AL 36640-0480
Phone (251) 434-3626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181029001835 TN Practitioner - Nurse Practitioner 7810240496 Reassigns benefits to 1 organization
I20201113000584 AL Practitioner - Nurse Practitioner 7810240496 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-179653ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Physician Billing Services LLC CurrentSince Aug 17, 2020 Accepting new patients
Summit Medical Group, PLLC CurrentSince Aug 6, 2018 Accepting new patients
Summit Medical Group, PLLC CurrentSince Aug 6, 2018 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Aug 17, 2020 Accepting new patients

Locations

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

1700 Center St
Mobile, AL 36604
Phone (251) 415-1000

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1568948990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40480",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366400480",
            "telephone_number": "251-434-3626",
            "fax_number": "251-445-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CENTER ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366043301",
            "telephone_number": "251-415-1055",
            "fax_number": "251-415-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJTALA",
        "first_name": "KATHLEEN",
        "middle_name": "QUINN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "24427",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-179653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.