Organization Active NPI

Comprehensive Pediatrics and Internal Medicine, LLC

  • Internal Medicine Physician
  • Hoover, AL
National Provider Identifier
1992339246
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMPREHENSIVE PEDIATRICS AND INTERNAL MEDICINE, LLC
Practice address
430 Emery Dr Ste 200
Hoover, AL 35244-4595
Phone
(205) 855-0357
NPI assigned
Feb 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
Marquisha Moore Jarmon, MDNPI 1013085679
Title
Owner/MD
Phone
(901) 288-3280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

430 Emery Dr Ste 200
Hoover, AL 35244-4595

Mailing address

430 Emery Dr Ste 200
Hoover, AL 35244-4595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200422001824 AL Part B Supplier - Clinic/Group Practice 7911337597 Receives reassigned benefits from 2 practitioners
Practice locations: Hoover, AL
O20210326001984 AL Part B Supplier - Mass Immunization (Roster Biller Only) 7911337597 Practice locations: Hoover, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2181472Comprehensive Pediatrics and Internal Medicine, LL430 Emery Drive, Suite 200, Hoover, AL 35244Certificate of waiverApr 5, 2028

National Provider Directory

National Provider Directory

Locations

430 Emery Dr
Ste 200
Hoover, AL 35244
Phone (205) 855-0357

430 Emery Dr
Ste 300
Hoover, AL 35244

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1992339246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 EMERY DR STE 200",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 EMERY DR STE 200",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444595",
            "telephone_number": "205-855-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PEDIATRICS AND INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "MOORE JARMON",
        "authorized_official_first_name": "MARQUISHA",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "901-288-3280",
        "authorized_official_credential": "MD"
    },
    "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 Hoover, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.