PROVIDENCE HEALTHCARE SERVICES (NPI# 1013113760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013113760 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTHCARE SERVICES |
| Other Organization Name | PROVIDENCE MEDICAL GROUP |
| Practice Address |
6701 Airport Blvd Suite B127 Mobile AL 36608-6705 |
| Mailing Address |
Po Box 850489 Mobile AL 36685-0489 |
| Practice Telephone | 2516313490 |
| Practice Fax Number | 2516313461 |
| Mailing Telephone | 2513423949 |
| Mailing Fax Number | 2516313361 |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2012-09-17 |
| Authorized Official Name | MR. CLARK P. CHRISTIANSON (PRESIDENT) |
| Authorized Official Telephone | 2516313574 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 529907120 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801188503 | Providence Healthcare Services | Obstetrics & Gynecology | 253 Professional Ln, Gulf Shores, AL 36542-3461 | 2011-05-12 |
| 1912101981 | Providence Healthcare Services | Family Medicine | 6901 Airport Blvd, Mobile, AL 36608-3795 | 2007-06-13 |
| 1902000102 | Providence Healthcare Services | Family Medicine | 19140 S 3rd St, Citronelle, AL 36522-2306 | 2007-06-12 |
| 1700080009 | Providence Healthcare Services | Family Medicine | 18 C.m. Rambo Drive, Saraland, AL 36571-2151 | 2007-06-12 |
| 1740484955 | Providence Healthcare Services | Family Medicine | 8833 Cottage Hill Rd, Mobile, AL 36695-8345 | 2007-06-12 |
| 1124222427 | Providence Healthcare Services | Family Medicine | 5100 Rangeline Road North, Mobile, AL 36619-9504 | 2007-06-12 |
| 1215214283 | Providence Healthcare Services | Family Medicine | 5100 Rangeline Road North, Mobile, AL 36619-9504 | 2011-11-04 |
| 1164683595 | Providence Healthcare Services | Obstetrics & Gynecology | 29653 Anchor Cross Blvd, Daphne, AL 36526-9594 | 2008-06-18 |
| 1679751226 | Providence Healthcare Services | Family Medicine | 18 C.m. Rambo Drive, Saraland, AL 36571-2151 | 2008-02-06 |
| 1386848356 | Providence Healthcare Services | Internal Medicine | 6701 Airport Blvd, Suite A101, Mobile, AL 36608-6705 | 2007-06-13 |
| Street Address |
6701 AIRPORT BLVD SUITE B127 |
| City | MOBILE |
| State | AL |
| Zip Code | 36608-6705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053313312 | Richard O Nenstiel | Physician Assistant | 6701 Airport Blvd, Suite D146, Mobile, AL 36608 | 2005-06-01 |
| 1508392432 | University of South Alabama Health Care Authority | Internal Medicine | 6701 Airport Blvd, A101, Mobile, AL 36608-6705 | 2017-05-11 |
| 1093241671 | Alabama Providence Healthcare Services | Otolaryngology | 6701 Airport Blvd, Suite B123, Mobile, AL 36608-6705 | 2017-05-03 |
| 1588109599 | Citrin Cardiology PC | Internal Medicine | 6701 Airport Blvd, Suite C138, Mobile, AL 36608-3784 | 2016-12-29 |
| 1629511753 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Ste B215, Mobile, AL 36608-6705 | 2016-11-21 |
| 1891245692 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite D143, Mobile, AL 36608-6705 | 2016-10-05 |
| 1386191740 | Leah Ambrose | Physician Assistant | 6701 Airport Blvd, Suite C138, Mobile, AL 36608-6705 | 2016-09-02 |
| 1386093953 | Terra Lynn Parnell | Nurse Practitioner | 6701 Airport Blvd, Suite D-330, Mobile, AL 36608 | 2016-06-06 |
| 1649634395 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite A-t06, Mobile, AL 36608-6705 | 2016-04-08 |
| 1558725200 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite B329, Mobile, AL 36608-6705 | 2016-04-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475524 | Grantham Dental, Inc. | Dentist | 3620 Springhill Memorial Drive South, Mobile, AL 36608 | 2020-10-21 |
| 1114540879 | Dearrius Hines | Home Health Aide | 1370 Lucerne Dr, Mobile, AL 36608 | 2020-05-28 |
| 1558980409 | Rachel Stevens | Registered Nurse | 8507 Tanner Williams Rd, Mobile, AL 36608 | 2020-04-10 |
| 1073170700 | Usa Health Physician Billing Services LLC | Otolaryngology | 5721 Usa Drive North, Hahn 1119, Mobile, AL 36608 | 2019-05-29 |
| 1952885600 | Franklin Primary Health Center Inc. | Dentist | 990 Cody Rd North, Mobile, AL 36608 | 2018-09-19 |
| 1114410040 | Zackary Elkins | Optometrist | 105 W I65 Service Rd N, Mobile, AL 36608 | 2018-06-14 |
| 1023562865 | Covenant Hospice, Inc. | Internal Medicine | 6801 Airport Blvd., Main Tower, 11th Floor North, Mobile, AL 36608 | 2016-08-10 |
| 1730575416 | Rayven Likely | Student in an Organized Health Care Education/Training Program | 1014 Centerwood Dr, Mobile, AL 36608 | 2015-04-09 |
| 1598040461 | Robert S Harlin | Specialist | 75 Clarise Circle, Mobile, AL 36608 | 2011-10-11 |
| 1972884948 | Heidi Michelle Mcdermott | Physical Therapist | 5721 Usa Drive N, Hahn 2050, Mobile, AL 36608 | 2011-09-06 |
| Find all providers in zip 36608 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730131210 | Rodney P Rocconi | Obstetrics & Gynecology | 1660 Springhill Avenue, Mobile, AL 36640-0430 | 2006-05-16 |
| 1639174014 | Kenneth Carl Brewington | Obstetrics & Gynecology | 5 Mobile Infirmary Cir, Mobile, AL 36607-3513 | 2005-06-14 |
| 1285833863 | Diagnostic & Medical Oncology PC | Obstetrics & Gynecology | 1700 Spring Hill Ave, Suite 100, Mobile, AL 36604-1407 | 2007-07-13 |
| 1508078577 | Jennifer Y Pierce | Obstetrics & Gynecology | 1660 Spring Hill Ave, Mobile, AL 36604-1405 | 2007-05-04 |
| 1225051204 | William Joseph Roy Jr. | Obstetrics & Gynecology | 6701 Airport Blvd, Suite B127, Mobile, AL 36608-6705 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386087559 | David Warren Doo | Obstetrics & Gynecology | 619 19th St S # Wif10250, Birmingham, AL 35249-2570 | 2013-04-08 |
| 1801188503 | Providence Healthcare Services | Obstetrics & Gynecology | 253 Professional Ln, Gulf Shores, AL 36542-3461 | 2011-05-12 |
| 1033168547 | Mack N Barnes | Obstetrics & Gynecology | 500 Office Park Dr Ste 400, Mountain Brk, AL 35223-2457 | 2006-05-10 |
| 1023098571 | Tennessee Valley Gynecologic Oncology, PC | Obstetrics & Gynecology | 3601 Cci Drive, Suite 220, Huntsville, AL 35805 | 2006-01-20 |
| 1154701530 | Jillian A O'donnell | Obstetrics & Gynecology | 625 19th St S, Birmingham, AL 35233-1900 | 2015-06-01 |
| 1104183938 | Haller Jackson Smith | Obstetrics & Gynecology | 619 19th St S, Birmingham, AL 35249-1900 | 2012-04-18 |
| 1811209703 | Margaret Liang | Obstetrics & Gynecology | 1700 6th Ave S, Birmingham, AL 35233-1802 | 2010-07-08 |
| 1437309283 | Rebecca Arend | Obstetrics & Gynecology | 619 19th St S, Birmingham, AL 35249-3720 | 2008-09-29 |
| 1164683595 | Providence Healthcare Services | Obstetrics & Gynecology | 29653 Anchor Cross Blvd, Daphne, AL 36526-9594 | 2008-06-18 |
| 1861505323 | Groesbeck P Parham | Obstetrics & Gynecology | 619 19th Street South, Birmingham, AL 35233 | 2006-08-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.