JASON DOUGLAS MOELLINGER (NPI# 1629165535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629165535 |
| Entity Type | Individual |
| Full Name | JASON DOUGLAS MOELLINGER |
| Credential | MD |
| Practice Address |
3485 Independence Dr Homewood AL 35209-5603 |
| Practice Telephone | 2059300920 |
| Practice Fax Number | 2054450115 |
| Mailing Telephone | 2059300920 |
| Mailing Fax Number | 2054450115 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2013-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 0002078 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 150817 | 05 | |
| AL | BCBS | 511-37628 | 01 |
| AL | MEDICARE PTAN | 102I346820 | 01 |
| AL | MC NSC | 0366100001 | 01 |
| AL | CIGNA GOVERNMENT SERVICE PTAN | 0366100001 | 01 |
| Street Address |
3485 INDEPENDENCE DR |
| City | HOMEWOOD |
| State | AL |
| Zip Code | 35209-5603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861498370 | Brian J Larson | Radiology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2005-06-21 |
| 1497232458 | Mersadies Berlynn Orr | Nurse Practitioner | 3485 Independence Dr, Homewood, AL 35209-5603 | 2018-07-23 |
| 1649775412 | Bellamy Clarissa Davis | Physician Assistant | 3485 Independence Dr, Homewood, AL 35209-5603 | 2018-03-26 |
| 1831633098 | Krystle E Phillips | Physician Assistant | 3485 Independence Dr, Homewood, AL 35209-5603 | 2016-12-07 |
| 1265824395 | David Thomas Gilmore | Physician Assistant | 3485 Independence Dr, Homewood, AL 35209-5603 | 2015-02-26 |
| 1275890386 | Tyler Lewis Poston | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2012-04-13 |
| 1831489707 | Laura Ashley Martin | Physician Assistant | 3485 Independence Dr, Homewood, AL 35209-5603 | 2011-04-13 |
| 1770710915 | Alison Marie Parden | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2009-06-15 |
| 1073778452 | Michael Eric Brewer Jr. | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2008-07-24 |
| 1427218460 | Austin T Lutz | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2008-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793510 | Marissa M Mcintyre | Registered Nurse | 3401 Independence Drive, Suite 221, Birmingham, AL 35209 | 2019-11-01 |
| 1093284457 | Patriot Healthcare of Alabama, LLC | Family Medicine | 2045 Brookwood Medical Center Drive, Suite 1, Birmingham, AL 35209 | 2018-11-15 |
| 1164902268 | Lucy Johnston | Physician Assistant | 1602 Woodfern Dr, Homewood, AL 35209 | 2018-08-17 |
| 1881184646 | Wade Louis Grady | Specialist/Technologist | 800 Larkshore Drive, Birmingham, AL 35209 | 2018-05-16 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1396251542 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 120 Oxmoor Blvd Ste 100, Birmingham, AL 35209 | 2017-12-26 |
| 1376060954 | Hannah Holloway | Specialist/Technologist | 725 Crest Lane, Birmingham, AL 35209 | 2017-08-24 |
| 1558887463 | Paul A Rhodes | Nurse Practitioner | 631 Beacon Center Office Park, Suite 108, Birmingham, AL 35209 | 2017-08-22 |
| 1538542196 | Proteus Molecular and Clinical Lab LLC | Clinical Medical Laboratory | 218 Summit Pkwy, Suite 250, Homewood, AL 35209 | 2015-07-01 |
| 1124407739 | Randall Alban | Nurse Practitioner | 2100 Southbridge Parkway, Suite 650, Birmingham, AL 35209 | 2015-05-28 |
| Find all providers in zip 35209 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275890386 | Tyler Lewis Poston | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2012-04-13 |
| 1770710915 | Alison Marie Parden | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2009-06-15 |
| 1073778452 | Michael Eric Brewer Jr. | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2008-07-24 |
| 1427218460 | Austin T Lutz | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2008-06-12 |
| 1205026846 | Thomas D Holley | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2007-07-30 |
| 1942410386 | Jared Michael Cox | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2007-05-23 |
| 1548470800 | Andrew Marshall Strang | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2007-05-23 |
| 1871680785 | Leon Columbus Hamrick Jr. | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2006-10-10 |
| 1811939267 | William Courtenay Renneker Jr. | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2006-06-11 |
| 1629023205 | George W. Adams Jr. | Urology | 3485 Independence Dr, Homewood, AL 35209-5603 | 2006-05-23 |
| Find all providers in HOMEWOOD | ||||
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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.