NPIMap

Organization Active NPI

Obelisk Healthcare

  • Health Service Clinic/Center
  • Montgomery, AL
National Provider Identifier
1841472529
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
20243 Issued in AL
Legal business name
OBELISK HEALTHCARE
Practice address
4705 Woodmere Blvd
Montgomery, AL 36106-3078
Phone
(334) 558-0262
Fax
(334) 558-0267
NPI assigned
Dec 4, 2007
Last updated
Oct 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Authorized official

Name
Dionne Williams
Title
Office Manager
Phone
(334) 558-0262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 20243 AL Primary

Addresses

Primary practice location

4705 Woodmere Blvd
Montgomery, AL 36106-3078

Mailing address

4705 Woodmere Blvd
Montgomery, AL 36106-3078
Phone (334) 558-0262

Other identifiers 2

IdentifierTypeStateIssuer
515-21545OtherALBCBS ALABAMA
529922860MedicaidAL

National Provider Directory

National Provider Directory

Locations

4705 Woodmere Blvd
Montgomery, AL 36106
Phone (334) 558-0262

901 E South Blvd
Ste A
Montgomery, AL 36116
Phone (334) 280-2882

Practitioners & affiliated clinicians

Practitioners 8

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": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1841472529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063078",
            "telephone_number": "334-558-0262",
            "fax_number": "334-558-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063078",
            "telephone_number": "334-558-0262",
            "fax_number": "334-558-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBELISK HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DIONNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-558-0262"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AL",
            "license": "20243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ALABAMA",
            "identifier": "515-21545",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529922860",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.