NPIMap

Organization Active NPI

The University of South Alabama Family Practice

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
National Provider Identifier
1912385261
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
2530 Issued in AL
Legal business name
THE UNIVERSITY OF SOUTH ALABAMA FAMILY PRACTICE
Practice address
1504 Spring Hill Ave
1800
Mobile, AL 36604-3207
Phone
(251) 434-3661
NPI assigned
May 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Authorized official

Name
Renetta Denise Macmillan, RN
Title
Manager Clinical Operation
Phone
(251) 434-3661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 2530 AL Primary

Addresses

Primary practice location

1504 Spring Hill Ave
1800
Mobile, AL 36604-3207

Mailing address

3804 Cabana SQ
204
Mobile, AL 36609-7610
Phone (205) 523-1208

National Provider Directory

National Provider Directory
Tax ID family
University of South Alabama Health Services Foundation23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1504 Spring Hill Ave
#1800
Mobile, AL 36604
Phone (251) 434-3661

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430956800000",
    "number": "1912385261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 CABANA SQ",
            "address_2": "204",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366097610",
            "telephone_number": "205-523-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 SPRING HILL AVE",
            "address_2": "1800",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366043207",
            "telephone_number": "251-434-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE UNIVERSITY OF SOUTH ALABAMA FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2015-05-07",
        "status": "A",
        "authorized_official_last_name": "MACMILLAN",
        "authorized_official_first_name": "RENETTA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "MANAGER CLINICAL OPERATION",
        "authorized_official_telephone_number": "251-434-3661",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AL",
            "license": "2530",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 7, 2015; 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.