Internal Medicine Associates of Montgomery PC
Organization Active NPI Specialist · Montgomery, AL
NPI 1720106859 · NPPES record last updated Jan 9, 2017
Key facts
- NPI
- 1720106859
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- INTERNAL MEDICINE ASSOCIATES OF MONTGOMERY PC
- Practice address
- 6940 Winton Blount Blvd
Montgomery, AL 36117-3556 - Phone
- (334) 279-9211
- Fax
- (334) 279-9925
- NPI assigned
- Mar 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Candace Bridges
- Title
- Office Manager
- Phone
- (334) 279-9211
Practitioners 7
-
Erika Bolton, CRNP
-
Kirby Parker, MD
-
Lois J Schulman, M.D.
-
Lauren Sheffield Barnes, CRNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D0304366 | Internal Medicine Associates | Certificate of waiver | Apr 7, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040512000454 | AL | Part B Supplier - Clinic/Group Practice | 5991794034 |
Receives reassigned benefits from 7 practitioners Practice locations: Montgomery, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
6940 Winton Blount Blvd
Montgomery, AL 36117-3556
Mailing address
6940 Winton Blount Blvd
Montgomery, AL 36117-3556
Phone (334) 279-9211
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CK4854 | Other | AL | RAILROAD MEDICARE |
| 528600110 | Medicaid | AL |
Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.