MONTGOMERY PEDIATRIC ASSOC, P.A. (NPI# 1770532681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770532681 |
| Entity Type | Organization |
| Organization Name | MONTGOMERY PEDIATRIC ASSOC, P.A. |
| Practice Address |
420 Cotton Gin Rd Montgomery AL 36117-3557 |
| Practice Telephone | 3342609129 |
| Practice Fax Number | 3342609665 |
| Mailing Telephone | 3342609129 |
| Mailing Fax Number | 3342609665 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2011-04-15 |
| Authorized Official Name | MRS. VIKKI BERRY (OFFICE MANAGER) |
| Authorized Official Telephone | 3342609129 |
| Authorized Official Credential | OFFICE MANAGER |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
00006213 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 528301770 | 05 |
| Street Address |
420 COTTON GIN RD |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36117-3557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659329191 | James Wesley Rabon | Pediatrics | 420 Cotton Gin Rd, Montgomery, AL 36117-3557 | 2006-05-05 |
| 1346776796 | Abby Nixon | Nurse Practitioner | 420 Cotton Gin Rd, Montgomery, AL 36117-3557 | 2017-05-04 |
| 1679643076 | Daria J Anagnos | Pediatrics | 420 Cotton Gin Rd, Montgomery, AL 36117-3557 | 2006-11-09 |
| 1477502607 | John Herbert Sumners | Pediatrics | 420 Cotton Gin Rd, Montgomery, AL 36117-3557 | 2006-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061307 | Bhg Lxxiii, LLC | Clinic/Center | 1714 Platt Place, Montgomery, AL 36117 | 2020-10-22 |
| 1952945602 | East Montgomery Pediatrics LLC | Pediatrics | 337 St Lukes Drive, Montgomery, AL 36117 | 2019-11-05 |
| 1417421496 | Tiffany Webb | Specialist | 411 Twain Curve, E, Montgomey, AL 36117 | 2019-01-14 |
| 1013485374 | Montgomery Orthodontic Specialists | Dentist | 5833 Carmichael Road, Montgomery, AL 36117 | 2018-11-05 |
| 1770050791 | Blair Henderson Parks | Speech-Language Pathologist | 7088 University Court, Montgomery, AL 36117 | 2018-10-29 |
| 1629557822 | Evelyn F Crayton | Dietitian, Registered | 124 Elm Dr, Montgomery, AL 36117 | 2018-08-08 |
| 1194203414 | Coopers Mental Healh Consultations | Psychologist | 8743 Ridgestone Ct, Montgomery, AL 36117 | 2018-07-30 |
| 1063912301 | Gardenia Cove Mental Health PC | Psychiatry & Neurology | 6771 Taylor Circle, Montgomery, AL 36117 | 2018-02-13 |
| 1760900294 | Montgomery Auburn Homecare LLC | In Home Supportive Care | 2569 Bell Rd, Montgomery, AL 36117 | 2017-09-05 |
| 1336667120 | Alyssa Bryanna Swisher | Chiropractor | 2026 Berryhill Road, Montgomery, AL 36117 | 2017-09-01 |
| Find all providers in zip 36117 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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/certification - 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 |
|---|---|---|---|---|
| 1295871556 | Evelyn Simpkins Evans | Pediatrics | Health Services, Inc, 1845 Cherry Street, Montgomery, AL 36107-0365 | 2007-01-30 |
| 1063511582 | Adolescent & Pediatric Associates | Pediatrics | 2611 Woodley Park Dr, Montgomery, AL 36116-3834 | 2006-09-21 |
| 1659329191 | James Wesley Rabon | Pediatrics | 420 Cotton Gin Rd, Montgomery, AL 36117-3557 | 2006-05-05 |
| 1336228188 | Jeffrey A Simon | Pediatrics | 4700 Woodmere Blvd, Montgomery, AL 36106-3065 | 2006-11-03 |
| 1831298355 | Albert Z Holloway | Pediatrics | 2611 Woodley Park Dr, Montgomery, AL 36116-3834 | 2006-09-21 |
| 1417056938 | Theodore R Smith | Pediatrics | 2611 Woodley Park Dr, Montgomery, AL 36116-3834 | 2006-09-21 |
| 1477502607 | John Herbert Sumners | Pediatrics | 420 Cotton Gin Rd, Montgomery, AL 36117-3557 | 2006-05-06 |
| 1134177587 | Olivia Caridad Garcia | Pediatrics | 470 Taylor Rd, Suite 210, Montgomery, AL 36117-3563 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154810224 | Kids Clinic Pediatric and Adolescent Medicine | Pediatrics | 101 Stephen J White Memorial Blvd, Talladega, AL 35160-2106 | 2018-05-04 |
| 1023452406 | Samantha Veronica Hill | Pediatrics | The University of Alabama At Birmingham, 1600 5th Ave South, Birmingham, AL 35233 | 2013-04-29 |
| 1285960674 | Just Kidz Medical LLC | Pediatrics | 5466 Old Shell Rd, Ste. A, Mobile, AL 36608-3046 | 2009-10-20 |
| 1508011297 | Marshall Medical Center South Pediatric Hospital Services | Pediatrics | 227 Brittany Rd, Guntersville, AL 35976-5766 | 2008-11-21 |
| 1427252766 | Medpeds of Dothan Inc | Pediatrics | 318 Westgate Pkwy Ste 2, Dothan, AL 36303-2963 | 2007-06-12 |
| 1033276035 | Brenda Layton Mcgivern | Pediatrics | 300 W Pettus St, Demopolis, AL 36732-2830 | 2007-01-02 |
| 1205905361 | Imc-pediatric & Adolescent Medicine, LLC | Pediatrics | 4013 Airport Blvd Ste C, Mobile, AL 36608-2201 | 2006-11-06 |
| 1588683262 | Milton Stanhope Brasfield IIi | Pediatrics | 105 Hwy 80 East, Suite 205, Demopolis, AL 36732 | 2006-07-19 |
| 1629028642 | Carmel Health Network | Pediatrics | 1653 Springhill Ave, Mobile, AL 36604-1404 | 2006-05-11 |
| 1821077413 | Richard Mcconnell Freeman | Pediatrics | 2901 Corporate Park Dr, Opelika, AL 36801-7283 | 2006-01-11 |
| Find all providers with the same taxonomy | ||||
| City | MONTGOMERY |
| Zip Code | 36117 |
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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.