Im Clinic LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

IM CLINIC LLC

Practice address

420 Lowell Dr SE Ste 102
Huntsville, AL 35801-3755

Phone

(256) 258-9278

NPI assigned

Mar 7, 2018

Last updated

Jan 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Omer Iqbal, DONPI 1255713327

Title

Owner

Phone

(256) 258-9278

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17891/brand/1/csg/1/fhir/r4
• Direct secure messaging: omer.iqbal.1@17891.direct.athenahealth.com

Practitioners 5

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.

• Omer Iqbal, D.O.

  • Internal Medicine Physician
  • Huntsville, AL
  • NPI 1255713327
  Medicare reassignment NPD Authorized official
• Regan Nicole Jeffers, PA-C

  • Physician Assistant
  • Huntsville, AL
  • NPI 1942156476
  Medicare reassignment NPD
• Catherine Adams, PA-C

  • Physician Assistant
  • Huntsville, AL
  • NPI 1942875851
  Medicare reassignment
• Kelsey Dawn Taylor

  • Medical Physician Assistant
  • Huntsville, AL
  • NPI 1033867072
  Medicare reassignment
• Don Alan Evans, MD

  • Internal Medicine Physician
  • Huntsville, AL
  • NPI 1710969522
  NPD (past)

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672617600000",
    "number": "1609378520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 527",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358040527",
            "telephone_number": "256-258-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LOWELL DR SE STE 102",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013755",
            "telephone_number": "256-258-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IM CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-07",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A",
        "authorized_official_last_name": "IQBAL",
        "authorized_official_first_name": "OMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-258-9278",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": "DO.1670",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENDING",
            "identifier": "PENDING",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omer.iqbal.1@17891.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "420 Lowell Dr SE Ste 102",
            "city": "Huntsville",
            "state": "AL",
            "country_code": "US",
            "postal_code": "358013755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Internal Medicine Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.