Lena I Bedri, MD
Individual provider Active NPI Pediatrics Physician · Tuscaloosa, AL
NPI 1962590117 · NPPES record last updated Sep 25, 2018
Key facts
- NPI
- 1962590117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 00026345 (AL)
- Practice address
- 535 Jack Warner Pkwy NE
Suite K
Tuscaloosa, AL 35404-5751 - Phone
- (205) 758-6471
- Fax
- (205) 758-6472
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00026345 | AL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Surgical Associates LLC | Past | Accepting new patients |
Interoperability endpoints
- lena.bedri@crimped.direct.medconnect-inc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 00026345 | AL | |
| Pediatrics Physician | 208000000X | 00026345 | AL | Yes |
Addresses
Primary practice location
535 Jack Warner Pkwy NE
Suite K
Tuscaloosa, AL 35404-5751
Mailing address
535 Jack Warner Pkwy NE
Suite K
Tuscaloosa, AL 35404-5751
Phone (205) 758-6471
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104380 | Medicaid | AL |
Other providers in Tuscaloosa, AL
- Richard Beatty
- Samer Muhamad Beauti
- Mitchell Glen Beavers
- Jamaiyah Beck
- Jessica Marie Beckwith
- Stephanie B Bedsole
- Bree Beech
- Behavioral Health Care
- Ruth Ellen Behm
- Beverly Bell-Shambley
All providers in Tuscaloosa, AL · Pediatrics Physician 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 25, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.