Active NPI
Uchenna Grace Ifediba, MD
- Internal Medicine Physician
- Birmingham, AL
National Provider Identifier
1750422143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 19563
- Practice address
- 1300 Bessemer Rd
Birmingham, AL 35208-4326 - Phone
- (205) 929-0565
- Fax
- (205) 929-0564
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19563 | AL | Primary |
Addresses
Primary practice location
1300 Bessemer Rd
Birmingham, AL 35208-4326
Mailing address
5037 Castle Rock Dr
Shoal Creek, AL 35242-6438
Phone (205) 929-0565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051554813 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19563 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317686400000",
"number": "1750422143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5037 CASTLE ROCK DR",
"city": "SHOAL CREEK",
"state": "AL",
"postal_code": "352426438",
"telephone_number": "205-929-0565",
"fax_number": "205-929-0564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 BESSEMER RD",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352084326",
"telephone_number": "205-929-0565",
"fax_number": "205-929-0564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IFEDIBA",
"first_name": "UCHENNA",
"middle_name": "GRACE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2011-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AL",
"license": "19563",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051554813",
"state": "AL"
}
],
"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 Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.