NPIMap

Organization Active NPI

Cardiology Associates of Mobile Inc

Doing business as Cardiology Associates / Eastern Shore Internal Medicine

  • Internal Medicine Physician
  • Mobile, AL
National Provider Identifier
1861666711
Registry record updated Aug 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CARDIOLOGY ASSOCIATES OF MOBILE INC
Doing business as
Cardiology Associates / Eastern Shore Internal Medicine
Practice address
6701 Airport Blvd
Suite D-330
Mobile, AL 36608-6705
Phone
(251) 607-9797
NPI assigned
Apr 22, 2008
Last updated
Aug 28, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
CARDIOLOGY ASSOCIATES OF MOBILE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2017

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

Authorized official

Name
Dr. Gerry M Phillips, M.D.NPI 1124079603
Title
President/Chairman of Board
Phone
(251) 607-9797

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X AL Primary

Addresses

Primary practice location

6701 Airport Blvd
Suite D-330
Mobile, AL 36608-6705

Mailing address

6701 Airport Blvd
Suite D-330
Mobile, AL 36608-6705
Phone (251) 607-9797

Other identifiers 3

IdentifierTypeStateIssuer
0119053MedicaidMS
510-38007OtherALBLUE CROSS BLUE SHIELD
2510092OtherALUNITED HEALTHCARE

Other names 1

  • Cardiology Associates / Eastern Shore Internal Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000468 AL Part B Supplier - Clinic/Group Practice 5496640229 Receives reassigned benefits from 62 practitioners
1 other NPI on this enrollment
Practice locations: Fairhope, AL; Mobile, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Cardiology Associates

Locations

1903 Hand Ave
Bay Minette, AL 36507
Phone (251) 580-1701

188 Hospital Dr
Ste 100
Fairhope, AL 36532
Phone (251) 607-9797

188 Hospital Dr
Ste 202
Fairhope, AL 36532
Phone (251) 279-3794

1721 N McKenzie St
Foley, AL 36535
Phone (251) 607-9797

12831 6th St
Ste D
Lillian, AL 36549
Phone (251) 943-4100

911 Winter St
Lucedale, MS 39452
Phone (601) 766-0308

5907 Highway 90
Pascagoula, MS 39563
Phone (225) 769-1611

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 90

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.

View all 90

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503878400000",
    "number": "1861666711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD",
            "address_2": "SUITE D-330",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086705",
            "telephone_number": "251-607-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD",
            "address_2": "SUITE D-330",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086705",
            "telephone_number": "251-607-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOLOGY ASSOCIATES OF MOBILE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARDIOLOGY ASSOCIATES OF MOBILE INC",
        "enumeration_date": "2008-04-22",
        "last_updated": "2017-08-28",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "GERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/CHAIRMAN OF BOARD",
        "authorized_official_telephone_number": "251-607-9797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119053",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "510-38007",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2510092",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiology Associates / Eastern Shore Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.