Lisa Dianne Dove

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

491 Issued in AL

Practice address

619 19TH St S
P 915
Birmingham, AL 35233-1900

Phone

(205) 975-0512

Fax

(205) 975-6404

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Mountain Group Services, LLCGroup PAC ID 3678886256, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oak Mountain Group Services, LLC

  • Hospitalist Physician
  • Birmingham, AL
  • NPI 1366840761
  Medicare reassignment Care Compare group NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• Healthcare Plus Limited Liability Company

  • Specialist
  • Metairie, LA
  • NPI 1063927465

  AL

  Medicare reassignment NPD
• Wound Management Specialists, LLC

  • Nurse Practitioner
  • Flowood, MS
  • NPI 1972150084

  AL

  Medicare reassignment
• Neurology Neurodiagnostic Lab LLC

  • Neurology Physician
  • Pelham, AL
  • NPI 1417165127
  NPD (past)
• Orthopaedic Specialists of Alabama PC

  • Orthopaedic Surgery Physician
  • Birmingham, AL
  • NPI 1831133586
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1720155476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "address_2": "P 915",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-975-0512",
            "fax_number": "205-975-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "address_2": "P 915",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-975-0512",
            "fax_number": "205-975-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVE",
        "first_name": "LISA",
        "middle_name": "DIANNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA491",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PAYEE #529916450",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009943016",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adriene Nichole Douglas
• Kendra Mims Douglas, DO
• Matthew Alton Douglas, CRNA
• Ronald E Douglas, M.A., LPC
• Andrew Hunter Douthit, DMD
• Kareth Dow, DPT
• Ashley Dowd
• Itia Dowdell, PA-C
• Mary Katherine Dowdy, CRNA
• Andrew Jared Dowland, LMSW

• Medical Physician Assistant in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Medical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.