ALABAMA PROVIDENCE HEALTHCARE SERVICES (NPI# 1730613431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730613431 |
| Entity Type | Organization |
| Organization Name | ALABAMA PROVIDENCE HEALTHCARE SERVICES |
| Other Organization Name | PROVIDENCE MEDICAL GROUP - PEDIATRICS |
| Practice Address |
6908 Providence Park Dr S Mobile AL 36695-4600 |
| Mailing Address |
Po Box 850489 Mobile AL 36685-0489 |
| Practice Telephone | 2516603490 |
| Practice Fax Number | 2516603491 |
| Mailing Telephone | 2513423949 |
| Mailing Fax Number | 2516313361 |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2019-02-15 |
| Authorized Official Name | YESICA VIEYRA (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 2059397633 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 156183 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Medical Group - Pediatrics | Doing Business As Name - 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 |
| 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 |
| 1639533383 | Alabama Providence Healthcare Services | Hospitalist | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2016-04-08 |
| Street Address |
6908 PROVIDENCE PARK DR S |
| City | MOBILE |
| State | AL |
| Zip Code | 36695-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568419513 | Nancy Elaine Weible | Family Medicine | 6908 Providence Park Dr S, Mobile, AL 36695 | 2006-05-27 |
| 1962897454 | Stephanie M Bender | Internal Medicine | 6908 Providence Park Dr S, Mobile, AL 36695 | 2015-04-01 |
| 1699194449 | Stephanie Dawn Andrews | Nurse Practitioner | 6908 Providence Park Dr S, Mobile, AL 36695-4600 | 2014-04-09 |
| 1356571400 | Hari Krishnan Sivanandam | Pediatrics | 6908 Providence Park Dr S, Mobile, AL 36695-4600 | 2009-07-23 |
| 1285880799 | Amit Pant | Pediatrics | 6908 Providence Park Dr S, Mobile, AL 36695 | 2008-08-15 |
| 1467632521 | Vimla Praveni Bhagwandin | Pediatrics | 6908 Providence Park Dr S, Mobile, AL 36695-4600 | 2007-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677596 | Linda Jean Hayes | Counselor | 2146 Carson Court, Mobile, AL 36695 | 2020-10-22 |
| 1205447836 | Restore Therapy Services, Ltd | Physical Therapist | 6720 Grejot Road, Mobile, AL 36695 | 2020-08-17 |
| 1437774999 | Nicholas Alan Brautigam | Chiropractor | 960 Schillinger Rd S, Suite D, Mobile, AL 36695 | 2020-06-10 |
| 1891320412 | R3 Counseling Solutions, LLC | Social Worker | 1110 Hillcrest Road, Suite 1b, Mobile, AL 36695 | 2020-03-04 |
| 1649800079 | Tondalaya Denise Mack | Home Health | 1450 Leroy Stevens Rd, Apt35, Mobile, AL 36695 | 2020-01-24 |
| 1801367107 | Tera Walters Therapy LLC | Pediatrics | 2523 D'iberville Drive North, Mobile, AL 36695 | 2018-12-12 |
| 1023595279 | Hall & Oates Pt West Mobile, LLC | Physical Therapist | 2351 Dawes Road, Mobile, AL 36695 | 2018-07-20 |
| 1679069116 | Oculo-facial Consultants | Ophthalmology | 610 Providence Park Dr E Bldg 2, Mobile, AL 36695 | 2018-07-09 |
| 1669964318 | Tina Highsmith | Hearing Instrument Specialist | 2344 Schillinger Rd S, Building #2 Ste A, Mobile, AL 36695 | 2018-05-30 |
| 1023533858 | Reach Pediatric Therapy | Speech-Language Pathologist | 12485 Jeff Hamilton Rd, Mobile, AL 36695 | 2017-08-14 |
| Find all providers in zip 36695 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801367107 | Tera Walters Therapy LLC | Pediatrics | 2523 D'iberville Drive North, Mobile, AL 36695 | 2018-12-12 |
| 1629573928 | Kaitlyn Brown Parker | Pediatrics | 2451 Usa Medical Center Dr Rm 714, Mobile, AL 36617-2300 | 2018-03-28 |
| 1881149557 | Child Behavioral Resources LLC | Pediatrics | 6304 Piccadilly Square Dr Ste 3, Mobile, AL 36609-5143 | 2016-08-23 |
| 1013327097 | Charlotte Steelman Macdonell | Pediatrics | 1601 Center St Ste 1n, Mobile, AL 36604-1541 | 2014-04-30 |
| 1912271834 | Mobile Pediatric Clinic LLC | Pediatrics | 1835 Old Shell Rd, Mobile, AL 36607-3416 | 2012-02-24 |
| 1194011288 | Gulf Coast Pediatrics, LLC | Pediatrics | 5675 Three Notch Rd Ste C, Mobile, AL 36619-1617 | 2011-06-27 |
| 1376833319 | Nina Sheree Ford Johnson | Pediatrics | 4013c Airport Blvd, Mobile, AL 36608-2201 | 2011-04-11 |
| 1720305030 | Sonia Singh Grevenitis | Pediatrics | 6321 Piccadilly Square Dr Ste A, Mobile, AL 36609-5305 | 2010-04-26 |
| 1164746806 | Jennifer Gremse Adair | Pediatrics | 3920 Airport Blvd., Mobile, AL 36608-1622 | 2010-03-24 |
| 1538366190 | Nancy Oppenheimer Wood | Pediatrics | 610 Providence Park Dr E Ste 201, Mobile, AL 36695-4615 | 2007-06-28 |
| 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.