Organization Active NPI

Breastcare Center of Birmingham

  • Specialist
  • Birmingham, AL
National Provider Identifier
1740391002
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
00022902 Issued in AL
Legal business name
BREASTCARE CENTER OF BIRMINGHAM
Practice address
2006 Brookwood Medical Ctr Dr Ste 410
Birmingham, AL 35209-6823
Phone
(205) 877-2987
Fax
(205) 877-2983
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Donna Ingram
Title
Billing MGR/Credentialing
Phone
(205) 314-2452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 00022902 AL Primary

Addresses

Primary practice location

2006 Brookwood Medical Ctr Dr Ste 410
Birmingham, AL 35209-6823

Mailing address

2018 Brookwood Medical Ctr Dr
Pob Suite 305
Birmingham, AL 35209-6898
Phone (205) 877-2987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041122000800 AL Part B Supplier - Clinic/Group Practice 0143285825 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, AL

National Provider Directory

National Provider Directory

Locations

2018 Brookwood Medical Ctr Dr
Ste 305
Birmingham, AL 35209
Phone (205) 877-2767

2018 Brookwood Medical Ctr Dr
Ste 410
Birmingham, AL 35209

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1740391002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 BROOKWOOD MEDICAL CTR DR",
            "address_2": "POB SUITE 305",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096898",
            "telephone_number": "205-877-2987",
            "fax_number": "205-877-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 BROOKWOOD MEDICAL CTR DR STE 410",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096823",
            "telephone_number": "205-877-2987",
            "fax_number": "205-877-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREASTCARE CENTER OF BIRMINGHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-06-20",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "BILLING MGR/CREDENTIALING",
        "authorized_official_telephone_number": "205-314-2452"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "00022902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.