Organization Active NPI

Eastern Nephrology

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1790174027
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EASTERN NEPHROLOGY
Practice address
48 Medical Park Dr E
Ste151
Birmingham, AL 35235-3400
Phone
(205) 699-1632
Fax
(866) 546-2124
NPI assigned
Jan 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Authorized official

Name
Jacki Bailey, DOO
Title
Doo
Phone
(205) 699-1632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

48 Medical Park Dr E
Ste151
Birmingham, AL 35235-3400

Mailing address

48 Medical Park Dr E
Ste151
Birmingham, AL 35235-3400
Phone (205) 699-1632

Other identifiers 1

IdentifierTypeStateIssuer
1093896466OtherALNPI

National Provider Directory

National Provider Directory
Tax ID family
Eastern Nephrology2 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.

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1790174027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E",
            "address_2": "STE151",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353400",
            "telephone_number": "205-699-1632",
            "fax_number": "866-546-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E",
            "address_2": "STE151",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353400",
            "telephone_number": "205-699-1632",
            "fax_number": "866-546-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN NEPHROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JACKI",
        "authorized_official_title_or_position": "DOO",
        "authorized_official_telephone_number": "205-699-1632",
        "authorized_official_credential": "DOO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093896466",
            "state": "AL"
        }
    ],
    "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 Jan 9, 2015; 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.