Advanced Diagnostic Services, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

11940 Issued in AL

Legal business name

ADVANCED DIAGNOSTIC SERVICES, LLC

Practice address

1301 Mulberry St
Montgomery, AL 36106-1132

Phone

(334) 265-6153

Fax

(334) 265-6943

NPI assigned

May 19, 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

Dr. John A Jernigan, M.D.NPI 1881635480

Title

President

Phone

(334) 265-6153

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• John A. Jernigan, M.D.

  • Internal Medicine Physician
  • Montgomery, AL
  • NPI 1881635480
  Authorized official Same address or phone

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730132739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MULBERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061132",
            "telephone_number": "334-265-6153",
            "fax_number": "334-265-6943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MULBERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061132",
            "telephone_number": "334-265-6153",
            "fax_number": "334-265-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DIAGNOSTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JERNIGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-265-6153",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "AL",
            "license": "11940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Physiological Laboratory 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.