MR. SAMUEL O. S. IRVINE JR. (NPI# 1376590059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376590059 |
| Entity Type | Individual |
| Full Name | MR. SAMUEL O. S. IRVINE JR. |
| Credential | PA-C |
| Practice Address |
2871 Acton Road Suite 100 Birmingham AL 35243-2560 |
| Practice Telephone | 2059390023 |
| Practice Fax Number | 2059394180 |
| Mailing Telephone | 2059390023 |
| Mailing Fax Number | 2059394180 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2011-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA-189 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 009989995 | 05 | |
| AL | BLUE CROSS - 860 MONT RD | 051001143 | 01 |
| AL | BLUE CROSS - 48 MED PARK | 051001307 | 01 |
| AL | BLUE CROSS - 2660 10TH AV | 051001308 | 01 |
| AL | 009989985 | 05 | |
| AL | 009934027 | 05 |
| Street Address |
2871 ACTON ROAD SUITE 100 |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35243-2560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396791604 | Stanley K Lochridge | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-05-26 |
| 1356381685 | Parvez K Sultan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-06-07 |
| 1780623355 | Charles A Noyes | Physician Assistant | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-06-06 |
| 1245279751 | John B Casterline | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-06-06 |
| 1639118169 | John L Harlan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-06-06 |
| 1457390981 | John B Richardson Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-06-06 |
| 1255371787 | Mitchell S Willcutt | Physician Assistant | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-06-06 |
| 1689621351 | Stephen J Sentenn | Physician Assistant | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-05-28 |
| 1164479218 | Wendy W. Cornelius | Physician Assistant | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-05-27 |
| 1871549964 | Cardio-thoracic Surgeons, PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2871 Acton Road, Suite 100, Birmingham, AL 35243-2560 | 2006-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588205223 | See Inc | Optometrist | 200 Summit Blvd, Suite 168, Birmingham, AL 35243 | 2019-10-03 |
| 1619526829 | Kourtni Brooke Young | Nurse Anesthetist, Certified Registered | Grandview Medical Center, 3690 Grandview Parkway, Birmingham, AL 35243 | 2019-09-10 |
| 1548747942 | Kaitlyn Bennett | Occupational Therapist | 3140 Cahaba Heights Road, Suite 102, Vestavia, AL 35243 | 2018-07-27 |
| 1013407675 | Alabama Radiation Therapy Services | Radiology | 3670 Grandview Pkwy #100, Birmingham, AL 35243 | 2018-05-18 |
| 1184169559 | Olivia Diann Gaston | Behavioral Analyst | 3296 Cahaba Heights Rd., Milestones Behavior Group., Vestavia, AL 35243 | 2016-12-21 |
| 1679027841 | Aspire Physical Recovery Center At Cahaba River, LLC | Skilled Nursing Facility | 3070 Healthy Way, Vestavia, AL 35243 | 2016-08-05 |
| 1306203682 | Abbey Elizabeth Duke | Physician Assistant | 3690 Grandview Parkway, Birmingham, AL 35243 | 2016-01-18 |
| 1689078628 | Mary Camp | Occupational Therapist | 3140 Cahaba Heights Road Suite 102, Vestavia Hills, AL 35243 | 2014-10-20 |
| 1255757209 | Laura Romundstad | Nurse Practitioner | 3670 Grandview Parkway, Suite 100, Birmingham, AL 35243 | 2014-03-14 |
| 1841631199 | Seth Alexander Martin | Developmental Therapist | 3981 Kyle Lane, Milestones Behavior Consulting, Vestavia, AL 35243 | 2013-07-16 |
| Find all providers in zip 35243 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043603236 | Julie Boyd | Physician Assistant | 516 20th St S, Birmingham, AL 35233-2028 | 2015-03-11 |
| 1780950733 | Laura Nugent Bradley | Physician Assistant | 800 St. Vincent's Drive, Suite 700, Birmingham, AL 35205-1630 | 2012-03-23 |
| 1811290968 | Lacey Golden | Physician Assistant | 48 Medical Park Dr E Ste 255, Birmingham, AL 35235-3464 | 2010-12-13 |
| 1659693836 | Chelsea Bares | Physician Assistant | 2151 Highland Ave S Ste 200, Birmingham, AL 35205-4031 | 2010-02-16 |
| 1174797542 | Richard Gregory Winters | Physician Assistant | 701 19th Street South, Lhr 112, Birmingham, AL 35294-0001 | 2008-04-16 |
| 1972797686 | Vital Surg LLC | Physician Assistant | 1321 19th St S, Birmingham, AL 35205-4801 | 2007-09-05 |
| 1982710299 | Lisa Ledlow Kuntz | Physician Assistant | 52 Medical Park Drive East, Ste 307, Birmingham, AL 35235 | 2006-08-21 |
| 1114030947 | Iris Daniella Stuart | Physician Assistant | Uab Dept of Surgery Division of Plastic, Fot 1150 510 20th Street S., Birmingham, AL 35294-3411 | 2006-08-16 |
| 1184659393 | Linda Carolyn Langston | Physician Assistant | 1751 Charleston Way, Birmingham, AL 35216-4886 | 2006-07-12 |
| 1104889765 | Karen Elizabeth Connor | Physician Assistant | 3460 Manor Ln, #204, Birmingham, AL 35209-5666 | 2006-04-06 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35243 |
Please comment or provide details below to improve the information on MR. SAMUEL O. S. IRVINE JR..
| 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.