PROVIDENCE HOSPITAL (NPI# 1952390643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952390643 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HOSPITAL |
| Practice Address |
6801 Airport Blvd Mobile AL 36608-3709 |
| Mailing Address |
Po Box 851537 Mobile AL 36685-1537 |
| Practice Telephone | 2516331600 |
| Practice Fax Number | 2516331679 |
| Mailing Telephone | 2516331600 |
| Mailing Fax Number | 2516331679 |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2015-09-29 |
| Authorized Official Name | MR. TODD S. KENNEDY (PRESIDENT AND CEO) |
| Authorized Official Telephone | 2516331663 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QL0400X |
Clinic/Center Specialization: Lithotripsy |
Ambulatory Health Care Facilities | ||
| Y | 282N00000X | General Acute Care Hospital | 10385 | AL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS | 025 | 01 | |
| AL | H0S0090H | 05 | |
| MS STATE PUBLIC SCHOOLS | 200020413 | 01 | |
| AETNA | 6120570 | 01 | |
| US DEPT OF LABOR | 166828300 | 01 | |
| MEDICARE COMPLETE | 5000060 | 01 | |
| MS | 00220487 | 05 | |
| HEALTHSPRING | 10374 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134584667 | Providence Hospital | Clinic/Center | 3413 Olive Branch Dr, Silver Spring, MD 20904-4973 | 2015-12-29 |
| 1881891372 | Providence Hospital | Chronic Disease Hospital | 16400 N Park Dr Apt 1008, Southfield, MI 48075-4728 | 2007-06-28 |
| 1548486681 | Providence Hospital | General Acute Care Hospital | 10508 Keane Dr, Grass Lake, MI 49240-8803 | 2007-04-17 |
| 1932277050 | Providence Hospital | Rehabilitation Hospital | 6351 Woodside Dr, Theodore, AL 36582-6061 | 2006-11-30 |
| 1861057416 | Providence Hospital | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2180 | 2019-05-08 |
| 1861954638 | Providence Hospital | Emergency Medicine | 1150 Varnum St Ne, Washington, DC 20017-2180 | 2019-04-02 |
| 1710362496 | Providence Hospital | General Acute Care Hospital | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2015-07-23 |
| 1871922971 | Providence Hospital | Hospitalist | 6801 Airport Blvd, Hospitalist Dept., Mobile, AL 36608-3709 | 2013-11-08 |
| 1992133912 | Providence Hospital | Anesthesiology | 6801 Airport Blvd, Anesthesia Dept., Mobile, AL 36608-3709 | 2013-10-30 |
| 1659707149 | Providence Hospital | General Acute Care Hospital | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2013-09-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PROVIDENCE HOSPITAL | 914 S Scheuber Rd, Centralia, WA 98531-9027 |
| System for Award Management (SAM) Entities | PROVIDENCE HOSPITAL AND MEDICAL CENTERS | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 |
| Iowa Business Entities | PROVIDENCE HOSPITALITY PARTNERS LLC | 709 Clarkson St, Denver, CO 80218 |
| Colorado Business Entities | PROVIDENCE HOSPITALITY PARTNERS LLC | 1888 N Sherman St, Suite 610, Denver, CO 80203 |
| New York State Corporations | PROVIDENCE HOSPITALITY PARTNERS LLC | 1888 N Sherman St, Suite 610, Denver, Co 80203 |
| Street Address |
6801 AIRPORT BLVD |
| City | MOBILE |
| State | AL |
| Zip Code | 36608-3709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326041203 | David R. Hassell | Radiology | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2005-05-24 |
| 1457975708 | Chastity Dawn Huguley | Nurse Practitioner | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2020-06-02 |
| 1326690223 | Deanna D Ryan | Nurse Practitioner | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2019-07-10 |
| 1730744012 | Ashly M. Acosta | Nurse Practitioner | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2019-05-02 |
| 1306302948 | Kelsey Sims Welch | Nurse Practitioner | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2019-02-19 |
| 1528532140 | Robert Brooks Stephens Jr. | Nurse Anesthetist, Certified Registered | 6801 Airport Blvd, Mobile, AL 36608-3785 | 2019-01-16 |
| 1366913683 | Kristine Boyle | Pharmacist | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2018-12-15 |
| 1003392036 | Katherine Harrelson | Nurse Practitioner | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2018-07-12 |
| 1952819542 | Brooklyn Hamm | Nurse Anesthetist, Certified Registered | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2018-01-17 |
| 1033626528 | Lindsey Lovorn Diehl | Nurse Anesthetist, Certified Registered | 6801 Airport Blvd, Mobile, AL 36608-3709 | 2018-01-05 |
| 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 | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609311000 | Mobile Infirmary Association | General Acute Care Hospital | 1721 Spring Hill Ave, Mobile, AL 36604-1402 | 2016-12-21 |
| 1942498480 | University of South Alabama Hosptital | General Acute Care Hospital | 203 De Sales Ave, Mobile, AL 36607-2203 | 2007-10-10 |
| 1740295484 | Infirmary Health Hospitals, Inc | General Acute Care Hospital | 5600 Girby Rd, Mobile, AL 36693-3320 | 2006-07-30 |
| 1558364802 | Mobile Infirmary Association | General Acute Care Hospital | 3 Mobile Infirmary Cir, Mobile, AL 36607-3520 | 2005-05-31 |
| 1972138022 | University of South Alabama | General Acute Care Hospital | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-03-10 |
| 1619537412 | Usa Health Hospital Billing | General Acute Care Hospital | 3929 Airport Blvd, Mobile, AL 36609-1987 | 2019-06-14 |
| 1245890045 | Usa Health Hospital Billing | General Acute Care Hospital | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2019-06-14 |
| 1306323522 | Mobile Infirmary Association | General Acute Care Hospital | 5 Mobile Infirmary Cir, Mobile, AL 36607-3513 | 2018-07-20 |
| 1720465461 | Mobile Infirmary Association | General Acute Care Hospital | 5 Mobile Infirmary Cir, Mobile, AL 36607-3513 | 2015-05-01 |
| 1972944601 | Bruce Lowman,md LLC | General Acute Care Hospital | 6801 Airport Blvd, Mobile, AL 36685 | 2013-07-10 |
| 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.