| Pathway Healthcare Alabama Llc | |
|
48 Medical Park Dr E Ste 453 Birmingham AL 35235-3472 | |
| (844) 728-4929 | |
| Not Available |
| Full Name | Pathway Healthcare Alabama Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 48 Medical Park Dr E Ste 453, Birmingham, Alabama |
| Authorized Official Name and Position | Rita Rox (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 2052089312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathway Healthcare Alabama Llc 1000 Urban Center Dr Ste 600 Birmingham AL 35242 Ph: (615) 498-3788 | Pathway Healthcare Alabama Llc 48 Medical Park Dr E Ste 453 Birmingham AL 35235-3472 Ph: (844) 728-4929 |
| NPI Number | 1053855122 |
|---|---|
| Provider Enumeration Date | 12/08/2016 |
| Last Update Date | 11/08/2022 |
| Medicare PECOS PAC ID | 1658653548 |
|---|---|
| Medicare Enrollment ID | O20170130001952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053855122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | (* (Not Available)) | Primary |
| Provider Name | Brent E Boyett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235211129 PECOS PAC ID: 2668460759 Enrollment ID: I20040505001712 |
| Provider Name | Wendy L Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295906634 PECOS PAC ID: 7113006164 Enrollment ID: I20080502000236 |
| Provider Name | Magdi Tageldin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679661102 PECOS PAC ID: 2961694344 Enrollment ID: I20101004000669 |
| Provider Name | Sharon A Mbuko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780841957 PECOS PAC ID: 0648442129 Enrollment ID: I20111005000228 |
| Provider Name | Darlene Santamour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245656511 PECOS PAC ID: 1951524214 Enrollment ID: I20140514001490 |
| Provider Name | Thomas Riney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457341307 PECOS PAC ID: 6901863307 Enrollment ID: I20190117002281 |
| Provider Name | Ginger C Lowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144603325 PECOS PAC ID: 9133435993 Enrollment ID: I20190826002914 |
| Provider Name | Ann C Still |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811977135 PECOS PAC ID: 6709785124 Enrollment ID: I20191211001771 |
| Provider Name | Deborah Gross |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982717997 PECOS PAC ID: 2769438480 Enrollment ID: I20201110001322 |
| Provider Name | Billy Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225484561 PECOS PAC ID: 3870992050 Enrollment ID: I20211014000707 |
| Provider Name | Roy D Ary |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1639100712 PECOS PAC ID: 1658461140 Enrollment ID: I20211214002534 |
| Provider Name | Lindsay M Shipman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992309165 PECOS PAC ID: 0749650257 Enrollment ID: I20221227002057 |
| Provider Name | Sonja Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609836857 PECOS PAC ID: 3870590946 Enrollment ID: I20230612003349 |
| Provider Name | Tiffany Dupree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467904557 PECOS PAC ID: 2769825777 Enrollment ID: I20240207000352 |
| Provider Name | Stephen Taylor |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1447354907 PECOS PAC ID: 0941549810 Enrollment ID: I20240216002536 |
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