ALABAMA PROVIDENCE HEALTHCARE SERVICES (NPI# 1619306701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619306701 |
| Entity Type | Organization |
| Organization Name | ALABAMA PROVIDENCE HEALTHCARE SERVICES |
| Other Organization Name | PROVIDENCE MEDICAL GROUP |
| Practice Address |
5621 Cottage Hill Rd Mobile AL 36609-4210 |
| Mailing Address |
Po Box 850489 Mobile AL 36685-0489 |
| Practice Telephone | 2516662439 |
| Practice Fax Number | 2516663166 |
| Mailing Telephone | 2513423949 |
| Mailing Fax Number | 2516313361 |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2015-09-28 |
| Authorized Official Name | MR. TODD S. KENNEDY (PRESIDENT) |
| Authorized Official Telephone | 2516331660 |
| Is Organization Subpart | Y |
| Parent Organization Name | ALABAMA PROVIDENCE HEALTHCARE SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Medical Group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316464183 | Alabama Providence Healthcare Services | Family Medicine | 411 N Section St, Fairhope, AL 36532-2649 | 2017-08-23 |
| 1093241671 | Alabama Providence Healthcare Services | Otolaryngology | 6701 Airport Blvd, Suite B123, Mobile, AL 36608-6705 | 2017-05-03 |
| 1730613431 | Alabama Providence Healthcare Services | Pediatrics | 6908 Providence Park Dr S, Mobile, AL 36695-4600 | 2017-04-19 |
| 1447799861 | Alabama Providence Healthcare Services | Family Medicine | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2017-02-17 |
| 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 |
| 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 |
| 1851755581 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite B222, Mobile, AL 36608-6705 | 2016-04-08 |
| 1689038382 | Alabama Providence Healthcare Services | Specialist | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2016-04-08 |
| Street Address |
5621 COTTAGE HILL RD |
| City | MOBILE |
| State | AL |
| Zip Code | 36609-4210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336112788 | James A Hassell | Family Medicine | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2006-02-08 |
| 1447799861 | Alabama Providence Healthcare Services | Family Medicine | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2017-02-17 |
| 1104278829 | Ali Riza Nazari | Family Medicine | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2016-07-06 |
| 1710152582 | Tetyana G. Falkenberry | Family Medicine | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2008-04-23 |
| 1497959613 | Providence Healthcare Services | Internal Medicine | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2007-06-12 |
| 1043375918 | Renata Alma Wix-harris | Family Medicine | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2006-12-22 |
| 1679589162 | Julia Ann Boyd | Nurse Practitioner | 5621 Cottage Hill Rd, Mobile, AL 36609-4210 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698309 | Bhg Lxxii, LLC | Clinic/Center | 4373 Dowtowner Loop South, Suite A, Mobile, AL 36609 | 2020-10-26 |
| 1760036008 | Jesse David Schultz | Chiropractor | 3501 Montlimar Plaza Drive, Mobile, AL 36609 | 2019-07-25 |
| 1982267241 | Raqueal L. Williams | Registered Nurse | 406 Larose Dr., Mobile, AL 36609 | 2019-04-22 |
| 1588131924 | Angela Roney | Counselor | 705 Oak Circle Dr. East, Mobile, AL 36609 | 2018-10-24 |
| 1134617996 | Harley Michelle Oliver | Physician Assistant | 820 S. University Blvd Bldg 1, Suite 1b, Mobile, AL 36609 | 2018-04-27 |
| 1912420126 | Rural Urgent Care LLC | Clinic/Center | 6280 Grelot Road, Mobile, AL 36609 | 2017-07-19 |
| 1598128407 | Trisha Mcmillon | Counselor | 3929 Airport Blvd Ste 1-214, Mobile, AL 36609 | 2016-03-30 |
| 1437523347 | Sonya White D.d.s. PC | Dentist | 6309 Piccadilly Square Dr., Mobile, AL 36609 | 2015-11-17 |
| 1386913374 | Janis Marie Fausser | Pharmacist | 5705 Cottagehill Rd, Mobile, AL 36609 | 2011-12-20 |
| 1245524263 | Emily Chisholm | Physical Therapist | 1515 University Blvd. S., Mobile, AL 36609 | 2011-06-07 |
| Find all providers in zip 36609 | ||||
| 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 ALABAMA 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.