Southern Care Internal Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTHERN CARE INTERNAL MEDICINE PC

Practice address

10 Meadowview Dr
Hoover, AL 35242-7700

Phone

(205) 547-2323

Fax

(205) 995-0955

NPI assigned

Jul 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Amy L Illescas, MDNPI 1346269123

Title

Owner

Phone

(205) 547-2323

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy L Illescas, M.D.

  • Internal Medicine Physician
  • Hoover, AL
  • NPI 1346269123
  Medicare reassignment Care Compare group NPD Authorized official
• Shanyn Bailey, NP

  • Family Nurse Practitioner
  • Hoover, AL
  • NPI 1639584097
  Medicare reassignment Care Compare group NPD
• Brandie Weidman, NP

  • Family Nurse Practitioner
  • Birmingham, AL
  • NPI 1184031346
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1881972073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MEADOWVIEW DR",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352427700",
            "telephone_number": "205-547-2323",
            "fax_number": "205-995-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEADOWVIEW DR",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352427700",
            "telephone_number": "205-547-2323",
            "fax_number": "205-995-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CARE INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "ILLESCAS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-547-2323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth M. Southern

• Internal Medicine Physician in Hoover, AL
• Providers in Hoover, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.