UNIVERSITY OF SOUTH ALABAMA (NPI# 1114388667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114388667 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF SOUTH ALABAMA |
| Other Organization Name | USA CHILD ABUSE PEDIATRICS |
| Practice Address |
1601 Center St Ste 1n Mobile AL 36604-1541 |
| Mailing Address |
Po Box 40480 Mobile AL 36640-0480 |
| Practice Telephone | 2514105437 |
| Practice Fax Number | 2514343802 |
| Mailing Telephone | (251) 434-3626 |
| Mailing Fax Number | 2514452464 |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2017-08-03 |
| Authorized Official Name | GLEN OWEN BAILEY (CEO) |
| Authorized Official Telephone | 2514717118 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080C0008X |
Pediatrics Specialization: Child Abuse Pediatrics |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| USA Child Abuse Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962862078 | University of South Alabama | Internal Medicine | 75 S University Blvd Ucom 6000 B, Mobile, AL 36688-0002 | 2016-03-02 |
| 1972963064 | University of South Alabama | Internal Medicine | 2451 Fillingim St, Mastin Bldg 102, Mobile, AL 36617-2238 | 2016-03-02 |
| 1992013593 | University of South Alabama | Clinic/Center | 1119 Hahn, 5721 Usa North Drive, Mobile, AL 36688-0002 | 2010-09-16 |
| 1689995748 | University of South Alabama | General Acute Care Hospital | 251 Cox St Ste 100, Mobile, AL 36604-3302 | 2010-06-11 |
| 1235290628 | University of South Alabama | Case Management | 1714 Center St, Mobile, AL 36604-3301 | 2006-12-12 |
| 1992746838 | University of South Alabama | Internal Medicine | 5870 Alumni Cir, Mobile, AL 36688-0001 | 2006-06-10 |
| 1972138022 | University of South Alabama | General Acute Care Hospital | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-03-10 |
| 1760959613 | University of South Alabama | Clinic/Center | 1610 Center St Ste B, Mobile, AL 36604-1512 | 2018-10-30 |
| 1205303153 | University of South Alabama | Clinic/Center | 1610 Center St Ste B, Mobile, AL 36604-1512 | 2018-10-30 |
| 1295202141 | University of South Alabama | Clinic/Center | 1610 Center St Ste B, Mobile, AL 36604-1512 | 2018-10-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNIVERSITY OF SOUTH ALABAMA | 307 Univeristy Blvd 380 Administration Bldg, Mobile, AL 36688-3053 |
| Street Address |
1601 CENTER ST STE 1N |
| City | MOBILE |
| State | AL |
| Zip Code | 36604-1541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013327097 | Charlotte Steelman Macdonell | Pediatrics | 1601 Center St Ste 1n, Mobile, AL 36604-1541 | 2014-04-30 |
| 1417513995 | Alison Bealle Rudd | Nurse Practitioner | 1601 Center St Ste 1n, Mobile, AL 36604-1541 | 2019-05-10 |
| 1316430739 | Kaitlin Brantley | Nurse Practitioner | 1601 Center St Ste 1n, Mobile, AL 36604-1541 | 2018-06-11 |
| 1992163505 | University of South Alabama | Pediatrics | 1601 Center St Ste 1n, Mobile, AL 36604-1541 | 2016-02-10 |
| 1871987875 | Brian Gavan | Pediatrics | 1601 Center St Ste 1n, Mobile, AL 36604-1541 | 2015-03-27 |
| 1326432410 | Laurie Mccann | Pediatrics | 1601 Center St Ste 1n, Mobile, AL 36604-1541 | 2015-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013551449 | John F Kilpatrick | Social Worker | 1156 Springhill Avenue, Mobile, AL 36604 | 2019-10-29 |
| 1477036986 | Rachel Schneider | Specialist/Technologist | 1601 Center St Ste B, Mobile, AL 36604 | 2018-09-11 |
| 1891218194 | Transitional Care LLC | Nurse Practitioner | 1725 Springhill Avenue, Mobile, AL 36604 | 2017-07-19 |
| 1427404722 | Precision Orthotics & Prosthetics,llc | Durable Medical Equipment & Medical Supplies | 1557 Springhill Avenue, Mobile, AL 36604 | 2016-05-05 |
| 1851737746 | Robert P. Kobelja | Psychiatry & Neurology | 1601 Center St Ste 2s, Mobile, AL 36604 | 2013-05-17 |
| 1619233970 | Lisa Brown Bailey | Nurse Practitioner | 1700 Center Street--, Division of Neonatology, Mobile, AL 36604 | 2012-04-11 |
| 1023341773 | Rebecca Blankenhorn | Audiologist | 1610 Center St., Suite A, Mobile, AL 36604 | 2009-09-14 |
| 1700062684 | William-glenn Langley Hollingsworth | Counselor | 1156 Springhill Ave, Mobile, AL 36604 | 2008-01-10 |
| 1972715415 | Allison May Chung | Pharmacist | 1504 Springhill Dr, Rm 5225, Mobile, AL 36604 | 2007-05-04 |
| 1265504716 | Geriatric Specialists LLC | Internal Medicine | 1059 Palmetto St, Mobile, AL 36604 | 2006-11-13 |
| Find all providers in zip 36604 | ||||
| Taxonomy Code | 2080C0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Child Abuse Pediatrics |
| A Child Abuse Pediatrician serves as a resource to children, families and communities by accurately diagnosing abuse; consulting with community agencies on child safety; providing expertise in courts of law; treating consequences of abuse and neglect; directing child abuse and neglect prevention programs and participating on multidisciplinary teams investigating; and managing child abuse cases. |
| Notes: Source: American Board of Medical Specialties, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396303723 | Usa Health Physician Billing Services LLC | Pediatrics | 1601 Center St, Mobile, AL 36604-1541 | 2019-05-31 |
Please comment or provide details below to improve the information on UNIVERSITY OF SOUTH ALABAMA.
| 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.