NPIMap

Organization Active NPI

University of South Alabama

  • Pediatric Gastroenterology Physician
  • Mobile, AL
National Provider Identifier
1679934145
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
Legal business name
UNIVERSITY OF SOUTH ALABAMA
Practice address
1601 Center St Ste 1S
Mobile, AL 36604-1541
Phone
(251) 410-5437
Fax
(251) 434-3852
NPI assigned
Mar 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Glen Owen Bailey
Title
Ceo
Phone
(251) 471-7118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0206X Primary

Addresses

Primary practice location

1601 Center St Ste 1S
Mobile, AL 36604-1541

Mailing address

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

Other names 1

  • USA Gastroenterology- Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
University of South Alabama Mitchell Cancer Institute53 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679934145",
    "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": "1601 CENTER ST STE 1S",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041541",
            "telephone_number": "251-410-5437",
            "fax_number": "251-434-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTH ALABAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "OWEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "251-471-7118"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USA Gastroenterology- Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.