NPIMap

Organization Active NPI

Brookwood Womens Diagnostic Center, LLC

  • Radiology Clinic/Center
  • Birmingham, AL
National Provider Identifier
1770519001
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
11009 Issued in AL
Legal business name
BROOKWOOD WOMENS DIAGNOSTIC CENTER, LLC
Practice address
2006 Medical Center Dr Ste 112
Birmingham, AL 35209-6823
Phone
(205) 877-1000
NPI assigned
Jun 26, 2006
Last updated
May 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Authorized official

Name
Angela Gilbert
Title
Officer/Authorized Official
Phone
(214) 236-8249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 11009 AL Primary

Addresses

Primary practice location

2006 Medical Center Dr Ste 112
Birmingham, AL 35209-6823

Mailing address

PO Box 740799
Atlanta, GA 30374-0799
Phone (205) 877-2453

Other identifiers 4

IdentifierTypeStateIssuer
147728OtherGAFDA#
14247OtherHEALTH PARTNER
1486270OtherGAUMWA
16-10437OtherGAUHC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120223000508 AL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5890789366 Practice locations: Birmingham, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Brookwood Diagnostic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Locations

2006 Medical Center Dr
Ste 112
Homewood, AL 35209
Phone (205) 877-5200

Practitioners & affiliated clinicians

Practitioners 11

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": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620604800000",
    "number": "1770519001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740799",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740799",
            "telephone_number": "205-877-2453",
            "fax_number": "205-871-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 MEDICAL CENTER DR STE 112",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096823",
            "telephone_number": "205-877-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKWOOD WOMENS DIAGNOSTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-236-8249"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "AL",
            "license": "11009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FDA#",
            "identifier": "147728",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNER",
            "identifier": "14247",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1486270",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "16-10437",
            "state": "GA"
        }
    ],
    "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 May 10, 2021; 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.