NPIMap

Organization Active NPI

Providence Hospital

  • General Acute Care Hospital
  • Mobile, AL
National Provider Identifier
1952390643
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
10385 Issued in 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
Last updated
Sep 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Authorized official

Name
Mr. Todd S. Kennedy
Title
President and Ceo
Phone
(251) 633-1663

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lithotripsy Clinic/Center 261QL0400X
General Acute Care Hospital 282N00000X 10385 AL Primary

Addresses

Primary practice location

6801 Airport Blvd
Mobile, AL 36608-3709

Mailing address

PO Box 851537
Mobile, AL 36685-1537
Phone (251) 633-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 164

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 164

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1952390643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 851537",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366851537",
            "telephone_number": "251-633-1600",
            "fax_number": "251-633-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083709",
            "telephone_number": "251-633-1600",
            "fax_number": "251-633-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "251-633-1663",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QL0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Lithotripsy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AL",
            "license": "10385",
            "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 Sep 29, 2015; 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.