NPIMap

Organization Active NPI

University of Alabama at Birmingham

Doing business as University Optometric Group

  • Optometrist
  • Birmingham, AL
National Provider Identifier
1780791376
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
UNIVERSITY OF ALABAMA AT BIRMINGHAM
Doing business as
University Optometric Group
Practice address
1701 9TH Ave S
Birmingham, AL 35294
Phone
(205) 934-5161
Fax
(205) 975-6534
NPI assigned
Aug 23, 2006
Last updated
Jan 7, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF ALABAMAAT BIRMINGHAM SCHOOL OF OPTOMETRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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

Authorized official

Name
Mr. Richard Margison
Title
VP Financial Affairs
Phone
(205) 934-5493

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1701 9TH Ave S
Birmingham, AL 35294

Mailing address

1701 9TH Ave S
Birmingham, AL 35294
Phone (205) 934-5161

Other identifiers 1

IdentifierTypeStateIssuer
5283000160MedicaidAL

Other names 1

  • University Optometric Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000323 AL Part B Supplier - Clinic/Group Practice 3779487970 Receives reassigned benefits from 457 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Birmingham, AL; Selma, AL; Montgomery, AL

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Robert T Brown MD

Locations

1530 3rd Ave S
#2352
Birmingham, AL 35233

1701 9th Ave S
Birmingham, AL 35205
Phone (205) 934-5161

1701 9th Ave S
Birmingham, AL 35294

Practitioners & affiliated clinicians

Practitioners 3

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": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231286400000",
    "number": "1780791376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 9TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35294",
            "telephone_number": "205-934-5161",
            "fax_number": "205-975-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 9TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35294",
            "telephone_number": "205-934-5161",
            "fax_number": "205-975-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ALABAMA AT BIRMINGHAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF ALABAMAAT BIRMINGHAM SCHOOL OF OPTOMETRY",
        "enumeration_date": "2006-08-23",
        "last_updated": "2009-01-07",
        "status": "A",
        "authorized_official_last_name": "MARGISON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VP FINANCIAL AFFAIRS",
        "authorized_official_telephone_number": "205-934-5493",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5283000160",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Optometric Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 7, 2009; 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.