| Ch Mssp Services Al Llc | |
|
1 Perimeter Park S Ste 100n Birmingham AL 35243-3248 | |
| (337) 991-9276 | |
| Not Available |
| Full Name | Ch Mssp Services Al Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Perimeter Park S Ste 100n, Birmingham, Alabama |
| Authorized Official Name and Position | Nicole Howard (SR VP OF ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 3379919276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ch Mssp Services Al Llc 1509 Dulles Dr Lafayette LA 70506-3718 Ph: (337) 991-9276 | Ch Mssp Services Al Llc 1 Perimeter Park S Ste 100n Birmingham AL 35243-3248 Ph: (337) 991-9276 |
| NPI Number | 1063111979 |
|---|---|
| Provider Enumeration Date | 02/28/2023 |
| Last Update Date | 02/28/2023 |
| Medicare PECOS PAC ID | 4688039142 |
|---|---|
| Medicare Enrollment ID | O20230505001134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063111979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | John H Wagner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487634085 PECOS PAC ID: 9133180334 Enrollment ID: I20041021000272 |
| Provider Name | Tara Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700979788 PECOS PAC ID: 9032218557 Enrollment ID: I20070625000573 |
| Provider Name | Cassandra W Frieson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740269802 PECOS PAC ID: 8921288424 Enrollment ID: I20110215000550 |
| Provider Name | Kimberly Dawn Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205249869 PECOS PAC ID: 1254559024 Enrollment ID: I20140820002595 |
| Provider Name | Linda Sandra Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649687237 PECOS PAC ID: 1355569641 Enrollment ID: I20140828000914 |
| Provider Name | Matthew Hanserd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942524434 PECOS PAC ID: 0345489563 Enrollment ID: I20150323002283 |
| Provider Name | Merrill Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295132660 PECOS PAC ID: 5092029264 Enrollment ID: I20150731015503 |
| Provider Name | Tonya M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255787818 PECOS PAC ID: 6406140169 Enrollment ID: I20160803002727 |
| Provider Name | Shandellyn Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780823195 PECOS PAC ID: 4385930205 Enrollment ID: I20160901000493 |
| Provider Name | Jerelyn Tiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033652581 PECOS PAC ID: 1355622150 Enrollment ID: I20170111000080 |
| Provider Name | Katherine Hurtt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790221901 PECOS PAC ID: 9335416767 Enrollment ID: I20170606001503 |
| Provider Name | Emily Lacey Rettler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588184782 PECOS PAC ID: 2567738941 Enrollment ID: I20171031000410 |
| Provider Name | Rachel Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194235168 PECOS PAC ID: 1759637390 Enrollment ID: I20180711003724 |
| Provider Name | Michael Shane Hammett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417446832 PECOS PAC ID: 1850642489 Enrollment ID: I20180920003037 |
| Provider Name | Clelata N. Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093290991 PECOS PAC ID: 5799020046 Enrollment ID: I20181214002179 |
| Provider Name | Heather Culligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770054389 PECOS PAC ID: 1951643626 Enrollment ID: I20190429001762 |
| Provider Name | Shayna N Moulton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104301357 PECOS PAC ID: 0345577755 Enrollment ID: I20190808000188 |
| Provider Name | Leah Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124672191 PECOS PAC ID: 4880924117 Enrollment ID: I20190928000229 |
| Provider Name | Jessie Bonner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821644378 PECOS PAC ID: 4385975747 Enrollment ID: I20191016000849 |
| Provider Name | Arthur M. Estoque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952952400 PECOS PAC ID: 0042643264 Enrollment ID: I20191202002343 |
| Provider Name | Patty A. Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558962845 PECOS PAC ID: 5395156236 Enrollment ID: I20201124002456 |
| Provider Name | Sheri Lynn Tims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457813289 PECOS PAC ID: 0143637348 Enrollment ID: I20210407000007 |
| Provider Name | Kelli E. Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396323036 PECOS PAC ID: 5890102990 Enrollment ID: I20210407000345 |
| Provider Name | Zachary Tyler Sanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376162099 PECOS PAC ID: 9537567268 Enrollment ID: I20211012000466 |
| Provider Name | Christi L. Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083256465 PECOS PAC ID: 7517355878 Enrollment ID: I20211020000012 |
| Provider Name | Abby Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922644178 PECOS PAC ID: 9931597325 Enrollment ID: I20211104001811 |
| Provider Name | Anna Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073182127 PECOS PAC ID: 1557750445 Enrollment ID: I20211115002488 |
| Provider Name | Tiffany W. Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255725917 PECOS PAC ID: 8527370063 Enrollment ID: I20221104000255 |
| Provider Name | Krista Pritchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780203075 PECOS PAC ID: 7315343571 Enrollment ID: I20230801001899 |
| Provider Name | Brian Cooper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366678963 PECOS PAC ID: 0547426223 Enrollment ID: I20230822002539 |
| Provider Name | Chelsea G Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467168781 PECOS PAC ID: 0840640504 Enrollment ID: I20231221002496 |
| Provider Name | Nidra Wilson Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982473997 PECOS PAC ID: 1153773866 Enrollment ID: I20240118001927 |
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