Individual provider Active NPI

Marcia Katherine Des Jardin, MD

  • Maternal & Fetal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1912535659
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
47917 Issued in AL
Practice address
1700 6TH Ave S
Birmingham, AL 35233-1802
Phone
(205) 996-3130
NPI assigned
Mar 30, 2020
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 47917 AL Primary

Addresses

Primary practice location

1700 6TH Ave S
Birmingham, AL 35233-1802

Mailing address

PO Box 55310
Birmingham, AL 35255-5310

Other practice location 1

750 E Adams St
Syracuse, NY 13210-1834
Phone (315) 464-5540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807001376 AL Practitioner - Obstetrics/Gynecology 0446797526 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jul 1, 2024 Accepting new patients
University of Alabama at Birmingham Past Accepting new patients

Locations

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1912535659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331802",
            "telephone_number": "205-996-3130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101834",
            "country_code": "US",
            "telephone_number": "315-464-5540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DES JARDIN",
        "first_name": "MARCIA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "AL",
            "license": "47917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.