MOBILE GASTROENTEROLOGY, PC (NPI# 1124031141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124031141 |
| Entity Type | Organization |
| Organization Name | MOBILE GASTROENTEROLOGY, PC |
| Practice Address |
6701 Airport Blvd Suite A-208 Mobile AL 36608-6705 |
| Mailing Address |
Po Box 850489 Mobile AL 36685-0489 |
| Practice Telephone | 2516392101 |
| Practice Fax Number | 2516399122 |
| Mailing Telephone | 2516392101 |
| Mailing Fax Number | 2516399122 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-10-18 |
| Authorized Official Name | CHARLES EDWARD JOHNSON (PHYSICIAN AND CEO) |
| Authorized Official Telephone | 2516392101 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE GROUP PROVIDER | I960 | 01 |
| Street Address |
6701 AIRPORT BLVD SUITE A-208 |
| 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 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| 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 |
| 1295783181 | Robert D. Lerner | Internal Medicine | 1700 Springhill Ave, Suite 100, Mobile, AL 36604-1407 | 2006-05-04 |
| 1710943428 | Charles Herbert Brown | Internal Medicine | 119 N Lafayette Street, Mobile, AL 36604 | 2006-04-21 |
| 1053318030 | Susan Bonfili Fleet | Internal Medicine | 101 Memorial Hospital Dr, Suite 200, Mobile, AL 36608-1786 | 2005-07-05 |
| 1114585734 | Usa Health Physician Billing Services LLC | Internal Medicine | 75 S University Blvd Unit 6000, Mobile, AL 36608-3274 | 2019-05-29 |
| 1184112856 | Rajab Idriss | Internal Medicine | 75 S University Blvd Unit 6000, Mobile, AL 36608-3274 | 2018-04-27 |
| 1891008900 | Venkata Sumana Kumarappa | Internal Medicine | 1700 Spring Hill Ave Ste 100, Mobile, AL 36604-1416 | 2010-07-17 |
| 1710299847 | Hani Sabahi | Internal Medicine | 75 S University Blvd, Ucom 6000b, Mobile, AL 36688-0002 | 2010-07-06 |
| 1275788010 | Alabama Professional Care Inc | Internal Medicine | 578 Azalea Rd, #119, Mobile, AL 36609-1551 | 2008-11-20 |
| 1760572531 | Matthew Lehn Carnes | Internal Medicine | 1700 Spring Hill Ave Ste 100, Mobile, AL 36604-1416 | 2006-10-13 |
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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.