NPIMap

Organization Active NPI

Decatur General Hospital

  • Pediatrics Physician
  • Decatur, AL
National Provider Identifier
1780940494
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD29393 Issued in AL
Legal business name
DECATUR GENERAL HOSPITAL
Practice address
1215 7TH St SE
Suite 230
Decatur, AL 35601-3337
Phone
(256) 350-4855
Fax
(256) 350-4866
NPI assigned
Apr 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Authorized official

Name
Mr. Dean Griffin
Title
Ceo
Phone
(256) 341-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MD29393 AL Primary

Addresses

Primary practice location

1215 7TH St SE
Suite 230
Decatur, AL 35601-3337

Mailing address

PO Box 2239
Decatur, AL 35609-2239
Phone (256) 350-4855

Other identifiers 1

IdentifierTypeStateIssuer
118967MedicaidAL

Other names 1

  • Tanya D DeLaVergne, MD Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333670400000",
    "number": "1780940494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2239",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356092239",
            "telephone_number": "256-350-4855",
            "fax_number": "256-350-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 7TH ST SE",
            "address_2": "SUITE 230",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013337",
            "telephone_number": "256-350-4855",
            "fax_number": "256-350-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-341-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "MD29393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118967",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tanya D DeLaVergne, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; 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.