PROVIDENCE HEALTHCARE SERVICES (NPI# 1124222427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124222427 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTHCARE SERVICES |
| Other Organization Name | PROVIDENCE MEDICAL GROUP |
| Practice Address |
5100 Rangeline Road North Mobile AL 36619-9504 |
| Mailing Address |
Po Box 850489 Mobile AL 36685-0489 |
| Practice Telephone | 2516614454 |
| Practice Fax Number | 2516619843 |
| Mailing Telephone | 2513423949 |
| Mailing Fax Number | 2516313361 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2012-09-13 |
| Authorized Official Name | MR. CLARK P. CHRISTIANSON (PRESIDENT) |
| Authorized Official Telephone | 2516331660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 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 |
| 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 |
| 1013113760 | Providence Healthcare Services | Obstetrics & Gynecology | 6701 Airport Blvd, Suite B127, Mobile, AL 36608-6705 | 2007-06-21 |
| 1386848356 | Providence Healthcare Services | Internal Medicine | 6701 Airport Blvd, Suite A101, Mobile, AL 36608-6705 | 2007-06-13 |
| Street Address |
5100 RANGELINE ROAD NORTH |
| City | MOBILE |
| State | AL |
| Zip Code | 36619-9504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215214283 | Providence Healthcare Services | Family Medicine | 5100 Rangeline Road North, Mobile, AL 36619-9504 | 2011-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184263816 | Julia Cheryl Tritch | Registered Nurse | 5130 Southbend Drive West, Mobile, AL 36619 | 2019-12-28 |
| 1386058311 | Monica Leigh Postage | Pharmacist | 5245 Rangeline Service Road South, Mobile, AL 36619 | 2014-06-18 |
| 1548604739 | Tillman's Corner Dental, P.C. | Dentist | 5659 Three Notch Rd., Mobile, AL 36619 | 2013-04-18 |
| 1417248410 | Quyen Nguyen | Pharmacist | 5440-a Highway 90 West, Mobile, AL 36619 | 2011-04-25 |
| 1760791909 | Brenetta M. Carraway | Pharmacist | 5451 Halls Mill Road, Suite 14, Mobile, AL 36619 | 2010-10-06 |
| 1881841419 | Virginia Leigh Childress | Physical Therapist | 5320 Us Hwy 90 Service Rd, Mobile, AL 36619 | 2008-08-26 |
| 1952457855 | Infirmary Occupational Health, PC | Preventive Medicine | 5320 Us Hwy 90 West, Mobile, AL 36619 | 2007-01-25 |
| 1417035676 | Leslie G Lovorn | Pharmacist | 5440 U.S. Highway 90 West, Mobile, AL 36619 | 2006-11-02 |
| 1427149947 | Foster Chiropractic Group, PC | Chiropractor | 4400 B Rangeline Rd, Mobile, AL 36619 | 2006-09-28 |
| 1306942628 | Mobile Family Care Center,inc | Family Medicine | 5560 Nevius Road, Mobile, AL 36619 | 2006-09-15 |
| Find all providers in zip 36619 | ||||
| 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 |
| 1194806844 | Smith&gayle Medical Center | Family Medicine | 1159 Spring Hill Ave, Mobile, AL 36604-2725 | 2006-10-18 |
| 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.