Shoals Pediatric Group PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SHOALS PEDIATRIC GROUP PC

Practice address

208 Ana Dr
Florence, AL 35630-1750

Phone

(256) 766-3983

Fax

(256) 764-1554

NPI assigned

Sep 14, 2006

Last updated

Aug 22, 2020By 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

Mrs. Glenda Howard Marks

Title

Office Manager

Phone

(256) 766-3983

Specialties & licenses 1

Addresses

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

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.

• Gerald Richard Freeman, M.D.,PHD.

  • Pediatrics Physician
  • Florence, AL
  • NPI 1235234295
  NPD (past)
• Daniel James Hammond, M.D.

  • Pediatrics Physician
  • Florence, AL
  • NPI 1518062561
  NPD (past)
• Sarah Van Kelley, MD

  • Pediatrics Physician
  • Florence, AL
  • NPI 1538588603
  NPD (past)
• Judy Thompson Moore, M.D.

  • Pediatrics Physician
  • Florence, AL
  • NPI 1477658425
  NPD (past)
• Lauren Barrera Judkins, FNP-C

  • Family Nurse Practitioner
  • Fairview, TN
  • NPI 1699225367
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609971647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 ANA DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301750",
            "telephone_number": "256-766-3983",
            "fax_number": "256-764-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 ANA DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301750",
            "telephone_number": "256-766-3983",
            "fax_number": "256-764-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOALS PEDIATRIC GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "256-766-3983",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shoals Obstetrics and Gynecology LLC
• Shoals Orthopedics and Sports Medicine
• Shoals Orthopedics, PC
• Shoals Orthotics & Prosthetics,Inc
• Shoals Pediatric Dentistry, P.C.
• Shoals Senior Solutions (Home Instead Senior Care)
• Shoals Urological Associates PC
• Shoals Womens Health & Wellness, LLC
• Emily Danielle Shockley
• Vanessa L Sides

• Pediatrics Physician in Florence, AL
• Providers in Florence, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.