UNIVERSITY OF SOUTH ALABAMA (NPI# 1700241015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700241015 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF SOUTH ALABAMA |
| Other Organization Name | USA HEALTH |
| Practice Address |
2451 University Hospital Dr Mastin 102 Mobile AL 36617-2300 |
| Mailing Address |
Po Box 40480 Mobile AL 36640-0480 |
| Practice Telephone | 2514705890 |
| Mailing Telephone | 2514705842 |
| Mailing Fax Number | 2514705809 |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2020-04-02 |
| Authorized Official Name | MR. GLEN OWEN BAILEY (CEO/CONTRACT OFFICER) |
| Authorized Official Telephone | 2514717118 |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY OF SOUTH ALABAMA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| USA Health | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1601 Center St, Mobile, AL 366041541 | 2514343475 | |
| 75 S University Blvd, Mobile, AL 366083042 | 2516605555 | |
| 1015 Montlimar Dr Ste A210, Mobile, AL 366091743 | 2514607189 | |
| 1720 Center St Ste 103, Mobile, AL 366043300 | 2514151475 | |
| 1660 Spring Hill Ave Ste 3069, Mobile, AL 366041405 | 2516658000 | |
| 1610 Center St, Ste C, Mobile, AL 366041512 | 2514151496 | |
| 2451 University Hospital Dr, Mastin 101, Mobile, AL 366172300 | 2514458282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962862078 | University of South Alabama | Internal Medicine | 75 S University Blvd Ucom 6000 B, Mobile, AL 36688-0002 | 2016-03-02 |
| 1972963064 | University of South Alabama | Internal Medicine | 2451 Fillingim St, Mastin Bldg 102, Mobile, AL 36617-2238 | 2016-03-02 |
| 1992013593 | University of South Alabama | Clinic/Center | 1119 Hahn, 5721 Usa North Drive, Mobile, AL 36688-0002 | 2010-09-16 |
| 1689995748 | University of South Alabama | General Acute Care Hospital | 251 Cox St Ste 100, Mobile, AL 36604-3302 | 2010-06-11 |
| 1235290628 | University of South Alabama | Case Management | 1714 Center St, Mobile, AL 36604-3301 | 2006-12-12 |
| 1992746838 | University of South Alabama | Internal Medicine | 5870 Alumni Cir, Mobile, AL 36688-0001 | 2006-06-10 |
| 1972138022 | University of South Alabama | General Acute Care Hospital | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-03-10 |
| 1760959613 | University of South Alabama | Clinic/Center | 1610 Center St Ste B, Mobile, AL 36604-1512 | 2018-10-30 |
| 1205303153 | University of South Alabama | Clinic/Center | 1610 Center St Ste B, Mobile, AL 36604-1512 | 2018-10-30 |
| 1295202141 | University of South Alabama | Clinic/Center | 1610 Center St Ste B, Mobile, AL 36604-1512 | 2018-10-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNIVERSITY OF SOUTH ALABAMA | 307 Univeristy Blvd 380 Administration Bldg, Mobile, AL 36688-3053 |
| Alabama Business Registrations | University of South Alabama Health Care Authority | 307 University Blvd N Ad 170, Mobile, Al 36688-2, |
| Street Address |
2451 UNIVERSITY HOSPITAL DR MASTIN 102 |
| City | MOBILE |
| State | AL |
| Zip Code | 36617-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811011448 | Kurt J Knowles | Pathology | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2007-03-19 |
| 1477171510 | Loren Lonnie Jones | Registered Nurse | 2451 University Hospital Dr, Mastin 101, Mobile, AL 36617 | 2020-07-06 |
| 1700402021 | Hilary Harless | Nurse Practitioner | 2451 University Hospital Dr, Mstn 101, Mobile, AL 36617-2300 | 2020-06-23 |
| 1578184438 | Martha Mckinley | Nurse Practitioner | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-05-01 |
| 1003444373 | Frederick Joseph Rossi IIi | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-03-31 |
| 1063040376 | Dominique Moreno | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-03-31 |
| 1144858838 | Taylor Rae Cook | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-03-30 |
| 1457989063 | Tyler Joseph Kaelin | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-03-30 |
| 1609403831 | Earl Chandler Tedder | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-03-26 |
| 1255968301 | Oluwafunmiso Ibunkun Fagbongbe | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr, Mobile, AL 36617-2300 | 2020-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871118760 | Travis Berry | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr., Moorer Bldg. Room 120, Mobile, AL 36617 | 2020-06-16 |
| 1164064978 | Crystal Aerin Deweever | Counselor | 2400 Gordon Smith Dr., Mobile, AL 36617 | 2019-10-14 |
| 1871145938 | Sagar Kumar | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr. Rm 714, Mobile, AL 36617 | 2019-07-09 |
| 1639630882 | Sarah Anderson | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Drive, Moorer Bldg. Room 120, Mobile, AL 36617 | 2019-03-29 |
| 1215415120 | Fnu Sameeta | Student in an Organized Health Care Education/Training Program | 2451 Usa Med Center Drive, Moorer Building Room 120, Mobile, AL 36617 | 2018-08-02 |
| 1659857670 | Sara Roberta Avalos Hernandez | Student in an Organized Health Care Education/Training Program | 2451 Usa Medical Center Drive, Moorer Building, Rm 120, Mobile, AL 36617 | 2018-07-12 |
| 1669978359 | Colin Thomas Buckley | Student in an Organized Health Care Education/Training Program | 2451 Usa Medical Center Dr. Rm 714, Mobile, AL 36617 | 2018-04-02 |
| 1336644590 | Shuo Shawn Liu | Student in an Organized Health Care Education/Training Program | 2451 Usa Medical Center Dr., Moorer Bldg. Room 120, Mobile, AL 36617 | 2018-03-28 |
| 1609308741 | Kulwant Singh Bath | Student in an Organized Health Care Education/Training Program | 2451 Fillingim St Res Box 7th Floor, Mobile, AL 36617 | 2017-03-29 |
| 1780115238 | Lindsay Dianne Williams | Student in an Organized Health Care Education/Training Program | 2451 Fillingim St., Mst 709, Mobile, AL 36617 | 2017-03-27 |
| Find all providers in zip 36617 | ||||
| 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 | ||||
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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.