KEVIN BLASE DEANDRADE (NPI# 1174781017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174781017 |
| Entity Type | Individual |
| Full Name | KEVIN BLASE DEANDRADE |
| Credential | M.D. |
| Practice Address |
6701 Airport Blvd Suite A-107 Mobile AL 36608-6774 |
| Practice Telephone | 2514334700 |
| Mailing Telephone | 2514334700 |
| Mailing Fax Number | 2514358549 |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2019-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
30054 | AL | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
30054 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 1063477644 | 05 |
| Street Address |
6701 AIRPORT BLVD SUITE A-107 |
| City | MOBILE |
| State | AL |
| Zip Code | 36608-6774 |
| 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 | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730746454 | Usa Health Physician Billing Services LLC | Internal Medicine | 2451 University Hospital Dr Bldg C, Mobile, AL 36617-2300 | 2019-05-29 |
| 1689173684 | Cardiac Cin of Mobile LLC | Internal Medicine | 202c Government St, Mobile, AL 36602-2614 | 2018-02-05 |
| 1659833515 | Cal Care of Al II, LLC | Internal Medicine | 202c Government St, Mobile, AL 36602-2614 | 2019-04-01 |
| 1700348679 | Cal Care of Al, LLC | Internal Medicine | 202c Government St, Mobile, AL 36602-2614 | 2019-04-01 |
| 1053501676 | Arthur G Grant IIi | Internal Medicine | 6701 Airport Blvd Ste D330, Mobile, AL 36608-6758 | 2007-07-30 |
| 1609822162 | Hercules Panayiotou | Internal Medicine | 1700 Springhill Ave, Suite 100, Mobile, AL 36604-1407 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386809176 | Farah Al Khitan | Internal Medicine | 300 Medical Center Dr 401, Gadsden, AL 35903-1104 | 2008-07-22 |
| 1508993668 | Appalachian Cardiovascular Associates | Internal Medicine | 1990 Gault Ave N, Suite 200, Fort Payne, AL 35967-3418 | 2007-02-27 |
| 1619923844 | Craig Raymond Peterson | Internal Medicine | 19725 South Greeno Road, Fairhope, AL 36532-3843 | 2006-05-26 |
| 1639120819 | Cynthia June Anastas | Internal Medicine | 2045 Cecil Ashburn Dr Se, Suite 201, Huntsville, AL 35802-2563 | 2006-05-13 |
| 1386085793 | Ashwini Sharma | Internal Medicine | 273 Winton M Blount Loop, Montgomery, AL 36117-3507 | 2013-07-13 |
| 1144563792 | Hussein Abu Daya | Internal Medicine | 2000 6th Ave S, Birmingham, AL 35233-2110 | 2013-04-02 |
| 1699021972 | Wasiq Faraz Rawasia | Internal Medicine | 185 Mitylene Park Ln, Montgomery, AL 36117-7302 | 2012-07-24 |
| 1790057420 | Bama Heart Doc, P.C. | Internal Medicine | 100 Rice Mine Road Loop, Suite 104, Tuscaloosa, AL 35406-2425 | 2012-01-26 |
| 1700162278 | Alabama Heart & Vascular, P. C. | Internal Medicine | 2022 Brookwood Medical Ctr Dr, Suite 403, Birmingham, AL 35209-6808 | 2011-10-28 |
| 1992018675 | Pochana Gautam Reddy | Internal Medicine | 930 Franklin St Se, Huntsville, AL 35801-4312 | 2010-07-22 |
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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.