Providence Hospital
Organization Active NPI General Acute Care Hospital · Mobile, AL
NPI 1952390643 · NPPES record last updated Sep 29, 2015
Key facts
- NPI
- 1952390643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 10385 (AL)
- Legal business name
- PROVIDENCE HOSPITAL
- Practice address
- 6801 Airport Blvd
Mobile, AL 36608-3709 - Phone
- (251) 633-1600
- Fax
- (251) 633-1679
- NPI assigned
- Oct 17, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Todd S. Kennedy
- Title
- President and Ceo
- Phone
- (251) 633-1663
Other NPIs on the same Medicare enrollment 2
Practitioners 164
-
Ashly M. Acosta, CRNP
-
Randall Lee Adams Jr., CRNA
-
Robert Grant Allenbach, CRNA
-
Aston G Archibald, M.D.
-
Farida N Awan, M.D.
-
Rahel Aziz, MD
-
Shoukat Baig, M.D
-
Vernon R. Beaver, CRNA
-
Kenneth W Bennett, CRNA
-
Mohammed Berrou, M.D.
-
David C Braswell II, M.D.
-
Deborah Ivy Brown, FNP-C
-
Jaime Carroll, CRNP
-
Maribeth Collard Clark, CRNP
-
Merrilee Burg Coby, CRNA
-
Angel Cameron Courtney, CRNA
-
Lindsey Lovorn Diehl, DNP
-
Joel W Donald, CRNA
-
Andrew James Dotson, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051219000880 | AL | Part B Supplier - Clinic/Group Practice | 9830111871 |
Receives reassigned benefits from 161 practitioners 2 other NPIs on this enrollment Practice locations: Mobile, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lithotripsy Clinic/Center | 261QL0400X | |||
| General Acute Care Hospital | 282N00000X | 10385 | AL | Yes |
Addresses
Primary practice location
6801 Airport Blvd
Mobile, AL 36608-3709
Mailing address
PO Box 851537
Mobile, AL 36685-1537
Phone (251) 633-1600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 025 | Other | BLUE CROSS | |
| 166828300 | Other | US DEPT OF LABOR | |
| 6120570 | Other | AETNA | |
| 00220487 | Medicaid | MS | |
| 200020413 | Other | MS STATE PUBLIC SCHOOLS | |
| H0S0090H | Medicaid | AL | |
| 10374 | Other | HEALTHSPRING | |
| 5000060 | Other | MEDICARE COMPLETE |
Other providers in Mobile, AL
- Providence Healthcare Services, Inc.
- Providence Healthcare SVC
- Providence Home Medical Services, LLC
- Providence Hospital
- Providence Hospital
- Providence Hospital
- Adrian Pruett
- Jessica M Pruett
- Brooks Sheffield Pruitt
- Farren Pryor
All providers in Mobile, AL · General Acute Care Hospital in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.