NPIMap

Individual provider Active NPI

Edgar Alberto Gutierrez

  • Student in an Organized Health Care Education/Training Program
  • Birmingham, AL
National Provider Identifier
1588127351
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone
(205) 971-1257
NPI assigned
Apr 9, 2019
Last updated
Apr 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

3690 Grandview Pkwy
Birmingham, AL 35243-3326

Mailing address

3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone (205) 971-1257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250716002473 SC Practitioner - Diagnostic Radiology 3779015029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical Branch at Galveston, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Radiology Associates LLCGroup PAC ID 1658350764, 63 clinicians

Practice addresses (Care Compare)

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1916

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Radiology Associates LLC CurrentSince Jul 1, 2025 Accepting new patients
Musc Community Physicians CurrentSince Aug 11, 2025 Accepting new patients
Musc Community Physicians CurrentSince Aug 11, 2025 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

Organizations & group practices 3

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

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1588127351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3690 GRANDVIEW PKWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433326",
            "telephone_number": "205-971-1257"
        },
        {
            "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": "205-971-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "EDGAR",
        "middle_name": "ALBERTO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.