St Vincents St Clair LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

ST VINCENTS ST CLAIR LLC

Doing business as

St Clair Emergency Department

Practice address

2805 Dr John Haynes Dr
Pell City, AL 35125-1448

Phone

(205) 814-2104

Fax

(205) 814-2145

NPI assigned

Sep 29, 2005

Last updated

Sep 6, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

ST VINCENTS ST CLAIR LLCAs reported in NPPES

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

Authorized official

Name

Brandon Williams

Title

Cfo

Phone

(205) 814-2104

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• St Clair Emergency Department Doing business as

Part of

Alabama Health SVCS St

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504656000000",
    "number": "1780671495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 LOCKBOX 1061",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352461061",
            "telephone_number": "205-437-6098",
            "fax_number": "205-437-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 DR JOHN HAYNES DR",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351251448",
            "telephone_number": "205-814-2104",
            "fax_number": "205-814-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENTS ST CLAIR LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST VINCENTS ST CLAIR LLC",
        "enumeration_date": "2005-09-29",
        "last_updated": "2017-09-06",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-814-2104"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PROVIDER #",
            "identifier": "F856",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG - DPT OF LABOR",
            "identifier": "311653",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529919640",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR (OWCP)",
            "identifier": "167885300",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE OF AL",
            "identifier": "3901720",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Clair Emergency Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St Clair County Health Dept-Pell City Pat 1St CM
• St Clair County Health Dept-Pell City Prev Health Ed
• St Clair County Health Dept-Pell City Pri Care
• St Clair County Health Dept-Pell City VFC Immun
• St Clair Eye PLLC (St Clair Eye)
• St. Clair Emergency Physicians, LLC.
• St. Clair Health & Rehab, Inc. (St Clair Health & Rehab)
• Jennifer Joy St. John, CRNP
• St. Vincent's Home Health, LLC (Ascension at Home)
• St. Vincent's Home Medical Services, LLC (UAB St. Vincent's Home Medical Services)

• Emergency Medicine Physician in Pell City, AL
• Providers in Pell City, AL by specialty
• Emergency Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.