Icp Alabama, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

ICP ALABAMA, LLC

Practice address

2700 Corporate Dr Ste 200
Birmingham, AL 35242-2733

Phone

(855) 498-6767

Fax

(479) 968-1673

NPI assigned

Jun 20, 2018

Organization subpart

No

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

Authorized official

Name

Rodney Thomason

Title

Authorized Official

Phone

(479) 498-6747

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1801380001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 CORPORATE DR STE 200",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422733",
            "telephone_number": "855-498-6767",
            "fax_number": "479-968-1673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 S Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Russellville",
            "state": "AR",
            "postal_code": "728012339",
            "country_code": "US",
            "telephone_number": "479-498-6747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICP ALABAMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-20",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "THOMASON",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "479-498-6747"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Patrick E Ifediba, M.D.
• Uchenna Grace Ifediba, MD
• Ehimwenma Judith Igbinakenzua
• James Iheke
• Chukwuemeka Kevin Ikejiani

• Nurse Practitioner in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.