ALABAMA PROVIDENCE HEALTHCARE SERVICES (NPI# 1083043178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083043178 |
| Entity Type | Organization |
| Organization Name | ALABAMA PROVIDENCE HEALTHCARE SERVICES |
| Other Organization Name | PROVIDENCE MEDICAL GROUP |
| Practice Address |
610 Providence Park Dr E Bldg 1, Suite 102 Mobile AL 36695-4622 |
| Mailing Address |
Po Box 850489 Mobile AL 36685-0489 |
| Practice Telephone | 2516395070 |
| Practice Fax Number | 2516342994 |
| Mailing Telephone | 2513423949 |
| Mailing Fax Number | 2516313361 |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2015-09-28 |
| Authorized Official Name | MR. TODD S. KENNEDY (PRESIDENT) |
| Authorized Official Telephone | 2516331660 |
| Is Organization Subpart | Y |
| Parent Organization Name | ALABAMA PROVIDENCE HEALTHCARE SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Medical Group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316464183 | Alabama Providence Healthcare Services | Family Medicine | 411 N Section St, Fairhope, AL 36532-2649 | 2017-08-23 |
| 1093241671 | Alabama Providence Healthcare Services | Otolaryngology | 6701 Airport Blvd, Suite B123, Mobile, AL 36608-6705 | 2017-05-03 |
| 1730613431 | Alabama Providence Healthcare Services | Pediatrics | 6908 Providence Park Dr S, Mobile, AL 36695-4600 | 2017-04-19 |
| 1447799861 | Alabama Providence Healthcare Services | Family Medicine | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2017-02-17 |
| 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 |
| 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 |
| 1851755581 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite B222, Mobile, AL 36608-6705 | 2016-04-08 |
| 1689038382 | Alabama Providence Healthcare Services | Specialist | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2016-04-08 |
| Street Address |
610 PROVIDENCE PARK DR E BLDG 1, SUITE 102 |
| City | MOBILE |
| State | AL |
| Zip Code | 36695-4622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811990765 | Percy Vandorn Crocker | Otolaryngology | 610 Providence Park Dr E, Bldg 2, Suite 203, Mobile, AL 36695-4622 | 2005-05-24 |
| 1790272250 | Elizabeth Brooke Stewart | Family Medicine | 610 Providence Park Dr E, Mobile, AL 36695-4622 | 2018-04-19 |
| 1598214116 | Carolyn Waddell | Physician Assistant | 610 Providence Park Dr E, Mobile, AL 36695-4622 | 2016-09-23 |
| 1265861355 | Alabama Providence Healthcare Services | Internal Medicine | 610 Providence Park Dr E, Bldg 1, Suite 101, Mobile, AL 36695-4622 | 2013-11-08 |
| 1811249444 | Dedra Snow | Pharmacist | 610 Providence Park Dr E, Mobile, AL 36695-4622 | 2012-10-05 |
| 1063770709 | Jonathan Michael Holmes | Pediatrics | 610 Providence Park Dr E, Ste. 201, Mobile, AL 36695-4622 | 2012-05-01 |
| 1548460116 | Andrea Lamendola Thompson | Audiologist | 610 Providence Park Dr E, Bldg. 2 Suite 202, Mobile, AL 36695-4622 | 2007-07-23 |
| 1255535662 | Providence Healthcare Services | Internal Medicine | 610 Providence Park Dr E, Bldg. 1 Suite 102, Mobile, AL 36695-4622 | 2007-06-12 |
| 1235146499 | Barbara M. Williams | Nurse Practitioner | 610 Providence Park Dr E, Bldg 1 Suite 102, Mobile, AL 36695-4622 | 2006-08-01 |
| 1255345369 | Stephen Anthony Kahalley | Internal Medicine | 610 Providence Park Dr E, Bldg 1 Suite 102, Mobile, AL 36695-4622 | 2006-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677596 | Linda Jean Hayes | Counselor | 2146 Carson Court, Mobile, AL 36695 | 2020-10-22 |
| 1205447836 | Restore Therapy Services, Ltd | Physical Therapist | 6720 Grejot Road, Mobile, AL 36695 | 2020-08-17 |
| 1437774999 | Nicholas Alan Brautigam | Chiropractor | 960 Schillinger Rd S, Suite D, Mobile, AL 36695 | 2020-06-10 |
| 1891320412 | R3 Counseling Solutions, LLC | Social Worker | 1110 Hillcrest Road, Suite 1b, Mobile, AL 36695 | 2020-03-04 |
| 1649800079 | Tondalaya Denise Mack | Home Health | 1450 Leroy Stevens Rd, Apt35, Mobile, AL 36695 | 2020-01-24 |
| 1801367107 | Tera Walters Therapy LLC | Pediatrics | 2523 D'iberville Drive North, Mobile, AL 36695 | 2018-12-12 |
| 1023595279 | Hall & Oates Pt West Mobile, LLC | Physical Therapist | 2351 Dawes Road, Mobile, AL 36695 | 2018-07-20 |
| 1679069116 | Oculo-facial Consultants | Ophthalmology | 610 Providence Park Dr E Bldg 2, Mobile, AL 36695 | 2018-07-09 |
| 1669964318 | Tina Highsmith | Hearing Instrument Specialist | 2344 Schillinger Rd S, Building #2 Ste A, Mobile, AL 36695 | 2018-05-30 |
| 1023533858 | Reach Pediatric Therapy | Speech-Language Pathologist | 12485 Jeff Hamilton Rd, Mobile, AL 36695 | 2017-08-14 |
| Find all providers in zip 36695 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194105361 | Md Mobile Care, Inc | Family Medicine | 600 Clinic Drive Suite 2800, Mobile, AL 36688-0001 | 2015-06-03 |
| 1417349580 | Jasmine P Gaines | Family Medicine | 801 S University Blvd Ste D, Mobile, AL 36609-2949 | 2015-02-26 |
| 1871992834 | Focusal1010 | Family Medicine | 3165 Dauphin St, Mobile, AL 36606-4061 | 2014-08-15 |
| 1659665123 | William E Barber | Family Medicine | 1504 Springhill Ave, University of South Alabama, Department of Family Medicine, Rm 3414, Mobile, AL 36604-3273 | 2011-06-02 |
| 1598061517 | Affordable Medical Clinic of Alabama | Family Medicine | 4701 Airport Blvd, Suite 200, Mobile, AL 36608-3187 | 2011-02-09 |
| 1952617508 | Gmuc of Springhill LLC | Family Medicine | 4402 Old Shell Rd, Mobile, AL 36608-1912 | 2010-08-20 |
| 1356585301 | Keva Wontoria Collier | Family Medicine | 2889 Sollie Rd, 1321, Mobile, AL 36695-5532 | 2009-04-21 |
| 1912101981 | Providence Healthcare Services | Family Medicine | 6901 Airport Blvd, Mobile, AL 36608-3795 | 2007-06-13 |
| 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 |
| Find all providers in MOBILE | ||||
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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.