UNIVERSITY OF SOUTH ALABAMA (NPI# 1962862078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962862078 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF SOUTH ALABAMA |
| Other Organization Name | USA GASTROENTEROLOGY- ADULT |
| Practice Address |
75 S University Blvd Ucom 6000 B Mobile AL 36688-0002 |
| Mailing Address |
Po Box 40480 Mobile AL 36640-0480 |
| Practice Telephone | 2516605555 |
| Practice Fax Number | 2516605559 |
| Mailing Telephone | 2514343626 |
| Mailing Fax Number | 2514452464 |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2016-03-02 |
| Authorized Official Name | HARVEY IKNER (ASSO ADMIN OF AMBULATORY CLINICS) |
| Authorized Official Telephone | 2514701671 |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY OF SOUTH ALABAMA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| USA Gastroenterology- Adult | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1396225090 | University of South Alabama | Ambulance | 1700 Center St, Mobile, AL 36604-3301 | 2018-08-21 |
| 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 |
75 S UNIVERSITY BLVD UCOM 6000 B |
| City | MOBILE |
| State | AL |
| Zip Code | 36688-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144742453 | David Thomas Bailey | Physician Assistant | Univ. of S. Alabama Dept. of Pa Studies, 5721 Usa Drive North - Hahn 3124, Mobile, AL 36688 | 2017-07-10 |
| 1447783766 | Elijah Fox | Student in an Organized Health Care Education/Training Program | 1700 Center St., Cweb 1, Room 1538, Mobile, AL 36688 | 2017-04-04 |
| 1164855805 | Khaled Abdelmagid | Student in an Organized Health Care Education/Training Program | 1700 Center St, Cweb 1, Rm 1538, Mobile, AL 36688 | 2013-08-16 |
| 1154614428 | Karen Marlowe | Pharmacist | 650 Clinic Drive - Suite 2100, Mobile, AL 36688 | 2011-05-19 |
| 1770620239 | Claude Vincent Dwyer IIi | Radiologic Technologist | 307 University, Mobile, AL 36688 | 2007-01-31 |
| 1225661523 | Jacob Rosner | Student in an Organized Health Care Education/Training Program | 5795 Usa Drive North Csab 170, Mobile, AL 36688-0001 | 2020-02-15 |
| 1215569249 | Lisa K. Morris | Nurse Practitioner | 5721 Usa Drive North Hahn 2044, Mobile, AL 36688-0001 | 2020-02-07 |
| 1467014019 | Victoria Suzanne Henbest | Speech-Language Pathologist | 5721 Usa North Drive, Mobile, AL 36688-0001 | 2019-07-03 |
| 1730642513 | Tyler Lee Sturdivant | Clinical Nurse Specialist | 5721 Usa Drive North Hahn 4067, Mobile, AL 36688-0001 | 2019-04-09 |
| 1730648346 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 5870 Alumni Drive, Mobile, AL 36688-0001 | 2019-03-14 |
| Find all providers in zip 36688 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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 |
|---|---|---|---|---|
| 1295783181 | Robert D. Lerner | Internal Medicine | 1700 Springhill Ave, Suite 100, Mobile, AL 36604-1407 | 2006-05-04 |
| 1710943428 | Charles Herbert Brown | Internal Medicine | 119 N Lafayette Street, Mobile, AL 36604 | 2006-04-21 |
| 1053318030 | Susan Bonfili Fleet | Internal Medicine | 101 Memorial Hospital Dr, Suite 200, Mobile, AL 36608-1786 | 2005-07-05 |
| 1114585734 | Usa Health Physician Billing Services LLC | Internal Medicine | 75 S University Blvd Unit 6000, Mobile, AL 36608-3274 | 2019-05-29 |
| 1184112856 | Rajab Idriss | Internal Medicine | 75 S University Blvd Unit 6000, Mobile, AL 36608-3274 | 2018-04-27 |
| 1891008900 | Venkata Sumana Kumarappa | Internal Medicine | 1700 Spring Hill Ave Ste 100, Mobile, AL 36604-1416 | 2010-07-17 |
| 1710299847 | Hani Sabahi | Internal Medicine | 75 S University Blvd, Ucom 6000b, Mobile, AL 36688-0002 | 2010-07-06 |
| 1275788010 | Alabama Professional Care Inc | Internal Medicine | 578 Azalea Rd, #119, Mobile, AL 36609-1551 | 2008-11-20 |
| 1760572531 | Matthew Lehn Carnes | Internal Medicine | 1700 Spring Hill Ave Ste 100, Mobile, AL 36604-1416 | 2006-10-13 |
| 1477642890 | Cody Benton Barnett | Internal Medicine | 101 Memorial Hospital Dr, Suite 200, Mobile, AL 36608-1786 | 2006-10-12 |
| 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.