Imc -Gulf Orthopaedics LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

IMC -GULF ORTHOPAEDICS LLC

Practice address

1720 Spring Hill Ave FL 3
Mobile, AL 36604-1410

Phone

(251) 435-1164

Fax

(251) 435-1616

NPI assigned

May 11, 2021

Last updated

Sep 3, 2021By 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

Anthony Palazzo

Title

Vice President of Finance

Phone

(251) 435-1361

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 36

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.

• Blake David Bowden, MD

  • Orthopaedic Surgery Physician
  • Mobile, AL
  • NPI 1073960704
  Medicare reassignment NPD
• Travis Perry Bowen, DO

  • Sports Medicine (Family Medicine) Physician
  • Mobile, AL
  • NPI 1629569223
  Medicare reassignment NPD
• Justin Ford Brewer, PA-C

  • Physician Assistant
  • Mobile, AL
  • NPI 1922299783
  Medicare reassignment NPD
• Joey Franklin Carter, MD

  • Orthopaedic Surgery Physician
  • Fairhope, AL
  • NPI 1942208012
  Medicare reassignment NPD
• Martin Wesley Carter, CRNP

  • Family Nurse Practitioner
  • Mobile, AL
  • NPI 1659723856
  Medicare reassignment NPD
• Christopher Harris Choquette, CRNP

  • Acute Care Nurse Practitioner
  • Mobile, AL
  • NPI 1912442401
  Medicare reassignment NPD
• Karen Forte Cox, PA-C

  • Physician Assistant
  • Mobile, AL
  • NPI 1144261694
  Medicare reassignment NPD
• Jason Robert Determann, MD

  • Orthopaedic Surgery Physician
  • Fairhope, AL
  • NPI 1255566311
  Medicare reassignment NPD
• James Francis Fisher III, PA-C

  • Physician Assistant
  • Mobile, AL
  • NPI 1043600356
  Medicare reassignment NPD
• Russell Douglas Goode, MD

  • Orthopaedic Surgery Physician
  • Mobile, AL
  • NPI 1518278126
  Medicare reassignment NPD
• Sarah Catherine Goode, CRNP

  • Family Nurse Practitioner
  • Mobile, AL
  • NPI 1447794862
  Medicare reassignment NPD
• Michael Lee Granberry, MD

  • Orthopaedic Surgery Physician
  • Mobile, AL
  • NPI 1427058882
  Medicare reassignment NPD

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1639753171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 SPRING HILL AVE FL 3",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041410",
            "telephone_number": "251-435-1164",
            "fax_number": "251-435-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 SPRING HILL AVE FL 3",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041410",
            "telephone_number": "251-435-1164",
            "fax_number": "251-435-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMC -GULF ORTHOPAEDICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "PALAZZO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "251-435-1361"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greire Iliff, CRNP
• Timothy Marshall Iliff, M.D.
• Isabel Christine Illingworth
• Imc - Womens Health Alliance of Mobile LLC
• Imc -Gulf Orthopaedics LLC
• Imc -Gulf Orthopaedics LLC
• Imc Mobile Bay OBGYN Center PC
• Imc Mobile Medical Group
• Imc Otolaryngology Facial Plastic & Reconstructive Surgery, P.C.
• Imc Services for Seniors PC

• Orthopaedic Surgery Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Orthopaedic Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.