PROVIDENCE HEALTHCARE SERVICES (NPI# 1386848356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386848356 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTHCARE SERVICES |
| Other Organization Name | PROVIDENCE MEDICAL GROUP |
| Practice Address |
6701 Airport Blvd Suite A101 Mobile AL 36608-6705 |
| Mailing Address |
Po Box 850489 Mobile AL 36685-0489 |
| Practice Telephone | 2516338880 |
| Practice Fax Number | 2516332817 |
| Mailing Telephone | 2513423964 |
| Mailing Fax Number | 2516313361 |
| Enumeration Date | 2007-06-13 |
| 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 |
|---|---|---|---|---|---|
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal 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 |
| 1124222427 | Providence Healthcare Services | Family Medicine | 5100 Rangeline Road North, Mobile, AL 36619-9504 | 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 |
| Street Address |
6701 AIRPORT BLVD SUITE A101 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive 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 |
|---|---|---|---|---|
| 1962856732 | Timothy Kennedy | Internal Medicine | 6701 Airprot Blvd, Ste A101, Mobile, AL 36608-0000 | 2016-04-19 |
| 1902269400 | Cesar Moreno | Internal Medicine | 2451 University Hospital Dr Rm 714, Mobile, AL 36617 | 2016-04-01 |
| 1770979882 | Mason Gabriel Adams | Internal Medicine | 75 S University Blvd Ste 6000-b, Mobile, AL 36608-3271 | 2015-04-15 |
| 1083009930 | Mark Owusu | Internal Medicine | 2451 Fillingim St # 7th, Mobile, AL 36617 | 2015-03-30 |
| 1730573627 | Theresa Yarbrough | Internal Medicine | 75 S University Blvd Ste 6000-a, Mobile, AL 36608-3042 | 2015-03-27 |
| 1346689163 | Benjamin Ross Niland | Internal Medicine | 75 S University Blvd Unit 6000, Mobile, AL 36608-3274 | 2013-06-14 |
| 1902249303 | Symbol Health Solutions, LLC | Internal Medicine | 3765b Government Blvd, Mobile, AL 36693-4307 | 2013-04-16 |
| 1629411731 | Adhd Medical Clinic of Mobile, P.C. | Internal Medicine | 2404 Spring Hill Ave, Unit 114, Mobile, AL 36607-3029 | 2013-04-09 |
| 1578826293 | Waqar Ahmed Siddiqui | Internal Medicine | 2451 Fillingim St Ste 10g, Mobile, AL 36617-2238 | 2012-06-18 |
| 1972860641 | Katrina Alexis Chapman | Internal Medicine | 2451 Fillingim St Rm 714, Mobile, AL 36617-2238 | 2012-04-18 |
| Find all providers in MOBILE | ||||
Please comment or provide details below to improve the information on PROVIDENCE HEALTHCARE SERVICES.
| 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.