FIVE STAR DIAGNOSTICS LLC (NPI# 1558894576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558894576 |
| Entity Type | Organization |
| Organization Name | FIVE STAR DIAGNOSTICS LLC |
| Practice Address |
1028 Grande View Pass Maylene AL 35114-4004 |
| Practice Telephone | 2054781200 |
| Mailing Telephone | 2054781200 |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | CEDRIC SHANNON (OWNER/CEO) |
| Authorized Official Telephone | 2054781200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Alabama Business Registrations | Five Star Diagnostics LLC | 1028 Grande View Pass, Maylene, AL 35114 |
| Street Address |
1028 GRANDE VIEW PASS |
| City | MAYLENE |
| State | AL |
| Zip Code | 35114-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295100832 | Shannon Industries LLC | Early Intervention Provider Agency | 1028 Grande View Pass, Maylene, AL 35114-4004 | 2015-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952462491 | Terri Yevette Marsden | Nurse Anesthetist, Certified Registered | 119 Water Elm Dr, Maylene, AL 35114-4919 | 2006-12-12 |
| 1700275245 | Ellan Harris | Specialist/Technologist | 108 Paddington Sta, Maylene, AL 35114-5445 | 2015-01-21 |
| 1104467869 | Jessica C Willey | Occupational Therapist | 103 Mayfair Park, Alabaster, AL 35114-5457 | 2019-10-03 |
| 1841441664 | Patricia Pollard Howard | Chiropractor | 264 Parliament Pkwy, Maylene, AL 35114-5460 | 2008-10-10 |
| 1720613763 | Shalon Henderson | Registered Nurse | 100 Chinaberry Ln, Alabaster, AL 35114-5847 | 2020-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700275245 | Ellan Harris | Specialist/Technologist | 108 Paddington Sta, Maylene, AL 35114-5445 | 2015-01-21 |
| 1841441664 | Patricia Pollard Howard | Chiropractor | 264 Parliament Pkwy, Maylene, AL 35114-5460 | 2008-10-10 |
| 1952462491 | Terri Yevette Marsden | Nurse Anesthetist, Certified Registered | 119 Water Elm Dr, Maylene, AL 35114-4919 | 2006-12-12 |
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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 |
|---|---|---|---|---|
| 1093316259 | University of South Alabama Health Care Authority | Internal Medicine | 2503 Old Shell Rd, Mobile, AL 36607-3021 | 2020-11-04 |
| 1972963064 | University of South Alabama | Internal Medicine | 2451 Fillingim St, Mastin Bldg 102, Mobile, AL 36617-2238 | 2016-03-02 |
| 1700292786 | Hima Bindu Darapu | Internal Medicine | 2000 6th Avenue South, Kirklin Clinic, 4th Floor, Birmingham, AL 35233 | 2014-07-10 |
| 1215355425 | Se Young Suh | Internal Medicine | 1801 Pine St Ste 203, Montgomery, AL 36106-1154 | 2014-04-03 |
| 1043634991 | Malapuram Vasudha Reddy | Internal Medicine | 201 Sivley Rd Sw Ste 440, Huntsville, AL 35801 | 2014-02-13 |
| 1790106607 | Monica Carmen Chiang | Internal Medicine | 300 South Greeno Road, Suite B, Fairhope, AL 36532 | 2013-12-18 |
| 1073807871 | Farah Yasmeen Ghori-javed | Internal Medicine | 4500 Montevallo Rd Ste B101, Irondale, AL 35210 | 2011-06-09 |
| 1801076500 | Janelle Marie Townes | Internal Medicine | 50 Medical Park Dr E Ste 158, Birmingham, AL 35235-3401 | 2007-11-09 |
| 1982897625 | Charles Runels | Internal Medicine | 750 Downtowner Loop W Ste A, Mobile, AL 36609-5500 | 2007-08-27 |
| 1669500880 | Prakash Chand Kansal | Internal Medicine | 801 Princeton Avenue, Pob 1, Suite 332., Birmingham, AL 35211 | 2007-03-01 |
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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.