NPIMap

Organization Active NPI

DCH Provider Services, LLC

  • Internal Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1982103974
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DCH PROVIDER SERVICES, LLC
Practice address
809 University Blvd E
Tuscaloosa, AL 35401
Phone
(205) 333-4528
NPI assigned
Feb 6, 2018
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mr. Daniel Clay Conville
Title
Director, Physician Services
Phone
(205) 333-4528

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

809 University Blvd E
Tuscaloosa, AL 35401

Mailing address

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4528

Other practice location 1

809 University Blvd E
Tuscaloosa, AL 35401

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180504001564 AL Part B Supplier - Clinic/Group Practice 6800150517 Receives reassigned benefits from 86 practitioners
4 other NPIs on this enrollment
Practice locations: Fayette, AL; Northport, AL; Tuscaloosa, AL

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
DCH Pediatric Hospitalists5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 86

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 86

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1982103974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "35401",
            "telephone_number": "205-333-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "35401",
            "telephone_number": "205-333-4528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 University Blvd E",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "35401",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DCH PROVIDER SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "CONVILLE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "205-333-4528",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.