NPIMap

Organization Active NPI

Marshall Medical Center South Medical Specialists of North Alabama

  • Gastroenterology Physician
  • Guntersville, AL
National Provider Identifier
1760998223
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MARSHALL MEDICAL CENTER SOUTH MEDICAL SPECIALISTS OF NORTH ALABAMA
Practice address
55 Rowe Dr Ste C
Guntersville, AL 35976-7366
Phone
(256) 571-8810
Fax
(256) 571-8880
NPI assigned
Dec 20, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MARSHALL MEDICAL CENTER SOUTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Kathy B Nelson
Title
Cfo
Phone
(256) 894-6701

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

55 Rowe Dr Ste C
Guntersville, AL 35976-7366

Mailing address

PO Box 11407 Dept#8011
Birmingham, AL 35246-8011
Phone (256) 571-8810

Other practice location 1

2525 US Highway 431 Ste 220
Boaz, AL 35957-5967
Phone (256) 840-4840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180615001058 AL Part B Supplier - Clinic/Group Practice 5496000424 Receives reassigned benefits from 5 practitioners
Practice locations: Boaz, AL; Guntersville, AL

National Provider Directory

National Provider Directory
Part of
Boaz-Albertville Hospital

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1760998223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DEPT#8011",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352468011",
            "telephone_number": "256-571-8810",
            "fax_number": "256-571-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ROWE DR STE C",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359767366",
            "telephone_number": "256-571-8810",
            "fax_number": "256-571-8880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 US Highway 431 Ste 220",
            "address_purpose": "LOCATION",
            "city": "Boaz",
            "state": "AL",
            "postal_code": "359575967",
            "country_code": "US",
            "telephone_number": "256-840-4840",
            "fax_number": "256-840-4844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARSHALL MEDICAL CENTER SOUTH MEDICAL SPECIALISTS OF NORTH ALABAMA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARSHALL MEDICAL CENTER SOUTH",
        "enumeration_date": "2017-12-20",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "256-894-6701"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guntersville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.