Individual provider Active NPI

Claude E. Mouledous Jr., M.D.

  • Internal Medicine Physician
  • Mobile, AL
National Provider Identifier
1891719704
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00023677 Issued in AL
Practice address
4444 Demetropolis Rd
Mobile, AL 36619-9602
Phone
(251) 219-3758
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 060128 GA
Internal Medicine Physician 207R00000X 00023677 AL Primary

Addresses

Primary practice location

4444 Demetropolis Rd
Mobile, AL 36619-9602

Mailing address

9827 Bella Dr
Daphne, AL 36526-6259
Phone (770) 576-9763

Other identifiers 1

IdentifierTypeStateIssuer
222797307AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23677ALMDPharmacist
00023677ALMDInternal Medicine Physician
060128GAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1891719704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9827 BELLA DR",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365266259",
            "telephone_number": "770-576-9763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 DEMETROPOLIS RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366199602",
            "telephone_number": "251-219-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULEDOUS",
        "first_name": "CLAUDE",
        "middle_name": "E.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "060128",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00023677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222797307A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 29, 2022; 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.