NPIMap

Organization Active NPI

Alabama Providence Healthcare Services

Doing business as Providence Medical Group-Foley

  • Family Medicine Physician
  • Foley, AL
National Provider Identifier
1780043075
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Doing business as
Providence Medical Group-Foley
Practice address
1851 N McKenzie St
Suite 206
Foley, AL 36535-4700
Phone
(251) 342-3949
Fax
(251) 631-3361
NPI assigned
Feb 16, 2016
Last updated
Feb 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Authorized official

Name
Mr. Todd Kennedy
Title
President
Phone
(251) 633-8880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1851 N McKenzie St
Suite 206
Foley, AL 36535-4700

Mailing address

6701 Airport Blvd
Suite 143
Mobile, AL 36608-6705
Phone (251) 342-3949

Other identifiers 2

IdentifierTypeStateIssuer
156183MedicaidAL
102G702814OtherALMEDICARE

Other names 1

  • Providence Medical Group-Foley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Al Prov Hlthcr SRVS27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

6701 Airport Blvd
Ste 143
Mobile, AL 36608
Phone (850) 470-9288

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1780043075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD",
            "address_2": "SUITE 143",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086705",
            "telephone_number": "251-342-3949",
            "fax_number": "251-631-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 N MCKENZIE ST",
            "address_2": "SUITE 206",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365354700",
            "telephone_number": "251-342-3949",
            "fax_number": "251-631-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALABAMA PROVIDENCE HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-633-8880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156183",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "102G702814",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Medical Group-Foley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Foley, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.