Individual provider Active NPI

Donney Dwayne Mattox

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Birmingham, AL
National Provider Identifier
1821574021
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
1-117387 Issued in AL
Practice address
1600 7TH Ave S
Birmingham, AL 35233-1711
Phone
(205) 638-9175
NPI assigned
Jul 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 1-117387 AL Primary

Addresses

Primary practice location

1600 7TH Ave S
Birmingham, AL 35233-1711

Mailing address

1600 7TH Ave S
Birmingham, AL 35233-1711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200306002135 AL Practitioner - Nurse Practitioner 3577991405 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-117387ALMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC CurrentSince Jan 1, 2020 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jan 1, 2020 Accepting new patients

Locations

1600 7th Ave S
Birmingham, AL 35233
Phone (205) 638-9100

2000 6th Ave S
Birmingham, AL 35233
Phone (205) 731-9396

703 Volker Hall
Birmingham, AL 35294
Phone (205) 638-9587

619 19th St S
Birmingham, AL 35249

Interoperability endpoints

  • Direct secure messaging: dmattox21177@childrensofalabama.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1821574021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-638-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOX",
        "first_name": "DONNEY",
        "middle_name": "DWAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-11",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "AL",
            "license": "1-117387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.