Providence Medical Group - Medicare Primary Care in Mobile, AL

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Providence Medical Group is a medicare enrolled primary clinic (Internal Medicine) in Mobile, Alabama. The current practice location for Providence Medical Group is 6701 Airport Blvd, Suite A101, Mobile, Alabama. For appointments, you can reach them via phone at (251) 342-3949. The mailing address for Providence Medical Group is Po Box 850489, Mobile, Alabama and phone number is (251) 342-3949.

Providence Medical Group is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1245669514. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (251) 342-3949.

Contact Information

Providence Medical Group
6701 Airport Blvd
Suite A101
Mobile
AL 36608-6705
(251) 342-3949
(251) 631-3361

Map and Direction


Primary Care Clinic Profile

Full NameProvidence Medical Group
SpecialityInternal Medicine
Location6701 Airport Blvd, Mobile, Alabama
Authorized Official Name and PositionTodd S. Kennedy (PRESIDENT)
Authorized Official Contact2516331660
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Providence Medical Group
Po Box 850489
Mobile
AL 36685-0489

Ph: (251) 342-3949		Providence Medical Group
6701 Airport Blvd
Suite A101
Mobile
AL 36608-6705

Ph: (251) 342-3949

NPI Details:

NPI Number1245669514
Provider Enumeration Date11/06/2013
Last Update Date09/28/2015

Medicare PECOS Information:

Medicare PECOS PAC ID9638308430
Medicare Enrollment IDO20140127000341

Medical Identifiers

Medical identifiers for Providence Medical Group such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1245669514NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Secondary
207R00000XInternal Medicine (* (Not Available))Primary
207RE0101XInternal Medicine - Endocrinology, Diabetes & Metabolism (* (Not Available))Secondary
207RG0100XInternal Medicine - Gastroenterology (* (Not Available))Secondary
207RR0500XInternal Medicine - Rheumatology (* (Not Available))Secondary
208D00000XGeneral Practice (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Providence Medical Group acts as a billing entity for following providers:
Provider NameAlan J Sherman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1952315343
PECOS PAC ID: 2365422789
Enrollment ID: I20040724000203
Provider NameAlaina E Amato
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1790702595
PECOS PAC ID: 2163458035
Enrollment ID: I20050712000711
Provider NameRoss B Del Fierro
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1760406276
PECOS PAC ID: 4789673518
Enrollment ID: I20050802000569
Provider NameTerry P Bell
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1639186596
PECOS PAC ID: 8628009784
Enrollment ID: I20050829000328
Provider NameLynn H Porter
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1508874751
PECOS PAC ID: 3870524952
Enrollment ID: I20050829000548
Provider NameCarmen G May
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043264294
PECOS PAC ID: 5799704201
Enrollment ID: I20051114001166
Provider NameNeelam Khan
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427021435
PECOS PAC ID: 0547274433
Enrollment ID: I20060131000119
Provider NameJoel P Laughlin
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1578503496
PECOS PAC ID: 3779590732
Enrollment ID: I20060315000724
Provider NameMelville J Sternberg
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1861440604
PECOS PAC ID: 9436161858
Enrollment ID: I20060628000212
Provider NameIjaz M Iqbal
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1962451971
PECOS PAC ID: 8224033766
Enrollment ID: I20060915000509
Provider NameKaren L Jimenez
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1659395341
PECOS PAC ID: 6901808765
Enrollment ID: I20070207000171
Provider NameVimla Praveni Devi Bhagwandin
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1467632521
PECOS PAC ID: 5698857746
Enrollment ID: I20080128000611
Provider NameCynthia L Op't Holt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164546727
PECOS PAC ID: 7113010133
Enrollment ID: I20080212000647
Provider NameBrenda L Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487677068
PECOS PAC ID: 1052495710
Enrollment ID: I20080220000224
Provider NameClyde R Varner
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1316931256
PECOS PAC ID: 3870521784
Enrollment ID: I20080303000073
Provider NameShameer B Abrahim
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1255525945
PECOS PAC ID: 1850478678
Enrollment ID: I20080403000347
Provider NameJames A Hassell
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1336112788
PECOS PAC ID: 3375613128
Enrollment ID: I20080605000039
Provider NameDavid H Macrae
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1952325466
PECOS PAC ID: 4183777907
Enrollment ID: I20090727000586
Provider NameJames L Ruble
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1346256260
PECOS PAC ID: 9931254000
Enrollment ID: I20090826000501
Provider NameLee E Eslava
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1639125602
PECOS PAC ID: 3274689526
Enrollment ID: I20090929000076
Provider NameSarah E Joiner
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1568543767
PECOS PAC ID: 5597801068
Enrollment ID: I20091014000273
Provider NameCharles E Johnson
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1285675835
PECOS PAC ID: 3971508854
Enrollment ID: I20100405000317
Provider NameLawrence J Parker
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1629008123
PECOS PAC ID: 1557261484
Enrollment ID: I20100408000054
Provider NameWilliam L Case
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1235161498
PECOS PAC ID: 6608871587
Enrollment ID: I20100408000162
Provider NameMarla Lambert
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1508872557
PECOS PAC ID: 6406987122
Enrollment ID: I20100624000552
Provider NameThomas A Kessler
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1376559310
PECOS PAC ID: 0941331417
Enrollment ID: I20100628000122
Provider NameMonica T Moore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871810812
PECOS PAC ID: 8022149509
Enrollment ID: I20100628000265
Provider NameRobert Israel
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1841204443
PECOS PAC ID: 2264519396
Enrollment ID: I20100709000657
Provider NameBilly August
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1659326932
PECOS PAC ID: 9739212994
Enrollment ID: I20100809000790
Provider NameVictor S Taylor
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1790724458
PECOS PAC ID: 2466586656
Enrollment ID: I20100810000231
Provider NameTetyana G Falkenberry
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1710152582
PECOS PAC ID: 1052486008
Enrollment ID: I20100826001041
Provider NameEric C Johnson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1902812803
PECOS PAC ID: 3678697109
Enrollment ID: I20100903000801
Provider NameStephen A Kahalley
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1255345369
PECOS PAC ID: 2466577788
Enrollment ID: I20100909001171
Provider NameKathleen Webster
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1134133150
PECOS PAC ID: 6800088071
Enrollment ID: I20101006000317
Provider NameRobert Elmo Willett
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1760463756
PECOS PAC ID: 5496940421
Enrollment ID: I20101116000420
Provider NameDana M Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619289915
PECOS PAC ID: 0547456808
Enrollment ID: I20101129000395
Provider NameMohammad Alsharabati
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1174748180
PECOS PAC ID: 0749339539
Enrollment ID: I20101228000673
Provider NameWilliam Stephen Denson
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1760495907
PECOS PAC ID: 2769671270
Enrollment ID: I20110121000092
Provider NameNicole M Bodine
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780981159
PECOS PAC ID: 1850574120
Enrollment ID: I20110323000869
Provider NameTami L Dunne
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801192851
PECOS PAC ID: 2062695158
Enrollment ID: I20110328000458
Provider NameKimberly Donnellan
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1376762815
PECOS PAC ID: 1052435781
Enrollment ID: I20110727000043
Provider NameJohn S Keebler
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1326194358
PECOS PAC ID: 1759559263
Enrollment ID: I20110727000210
Provider NameJames F Benson
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1497862353
PECOS PAC ID: 7618978313
Enrollment ID: I20110809000333
Provider NameAmit Pant
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1285880799
PECOS PAC ID: 2264601897
Enrollment ID: I20110816000239
Provider NameAmy Woodward
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1427218759
PECOS PAC ID: 1951571355
Enrollment ID: I20110822000471
Provider NameErnest G Burch
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1477518926
PECOS PAC ID: 0941217616
Enrollment ID: I20111011000161
Provider NameVyshali M Reddy Loupe
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1659531440
PECOS PAC ID: 9032382569
Enrollment ID: I20111028000455
Provider NameRocio Aleman Hilpert
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1730484577
PECOS PAC ID: 9032380233
Enrollment ID: I20120327000150
Provider NameNancy Weible
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1568419513
PECOS PAC ID: 6305911157
Enrollment ID: I20120626000045
Provider NameBarbara Mccormick Naman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487975710
PECOS PAC ID: 8921264862
Enrollment ID: I20120723000338
Provider NameHari K Sivanandam
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1356571400
PECOS PAC ID: 4789834250
Enrollment ID: I20121017000852
Provider NameYanming Xing
Provider TypePractitioner - Rheumatology
Provider IdentifiersNPI Number: 1154594737
PECOS PAC ID: 1951547892
Enrollment ID: I20130726000095
Provider NameOscar L. Castro
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1093743288
PECOS PAC ID: 9133119555
Enrollment ID: I20130726000426
Provider NameThomas Foster
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1992962856
PECOS PAC ID: 5193973527
Enrollment ID: I20131030001757
Provider NameDarryl Morin
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1083892285
PECOS PAC ID: 9931272242
Enrollment ID: I20131231001078
Provider NameGale Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558785980
PECOS PAC ID: 3274756770
Enrollment ID: I20140602002690
Provider NameStephanie Dawn Andrews
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699194449
PECOS PAC ID: 4486878121
Enrollment ID: I20140619000236
Provider NameJoshua M Rivers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639599483
PECOS PAC ID: 6406071513
Enrollment ID: I20140703001400
Provider NamePreethi Reddy Marri
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1497918395
PECOS PAC ID: 4789855339
Enrollment ID: I20140916002468
Provider NameErin D Prendergast
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053711911
PECOS PAC ID: 7517188774
Enrollment ID: I20141031002199
Provider NameRosanne B Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821406026
PECOS PAC ID: 8123240355
Enrollment ID: I20141104000488
Provider NamePoovitha Ramasamy
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1932487055
PECOS PAC ID: 1850530296
Enrollment ID: I20141201000791
Provider NameKymberli L Sowell
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1578999058
PECOS PAC ID: 4183946171
Enrollment ID: I20141202001013
Provider NameLindsay Yarbrough
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1184935199
PECOS PAC ID: 0244469948
Enrollment ID: I20150112000904
Provider NameRobbie L Stringer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992194989
PECOS PAC ID: 9234456328
Enrollment ID: I20150330001868
Provider NameEmilie O'brien White Hallford
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1427318211
PECOS PAC ID: 5890935217
Enrollment ID: I20150722006222
Provider NameBrittany L Barnes
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1063770550
PECOS PAC ID: 7618116047
Enrollment ID: I20150729010018
Provider NameJoseph Ewing Bornstein
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1629205182
PECOS PAC ID: 7416110036
Enrollment ID: I20150916002611
Provider NameNakita J Milhouse-cook
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962881557
PECOS PAC ID: 9234439035
Enrollment ID: I20151201001062
Provider NameRobin R Collins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194979385
PECOS PAC ID: 4486795390
Enrollment ID: I20160303001427
Provider NameAshley Elizabeth Davis
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1790128429
PECOS PAC ID: 5698072015
Enrollment ID: I20160330002245
Provider NameScott A Doherty
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1730108093
PECOS PAC ID: 5991833865
Enrollment ID: I20160713001650
Provider NameSara Long Jones
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1053756809
PECOS PAC ID: 5991928061
Enrollment ID: I20160812001696
Provider NameKevin Michaels
Provider TypePractitioner - Preventive Medicine
Provider IdentifiersNPI Number: 1568430759
PECOS PAC ID: 8820383987
Enrollment ID: I20160829001067
Provider NameLori A Mcintosh
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1710956602
PECOS PAC ID: 6800890138
Enrollment ID: I20160829001843
Provider NameDe'arco R Mccreary
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1750624508
PECOS PAC ID: 7517181092
Enrollment ID: I20160831000433
Provider NameIrfan Hashmi
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1346601739
PECOS PAC ID: 1951697226
Enrollment ID: I20160913001319
Provider NameCrystal L Parks
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1760748172
PECOS PAC ID: 4981991262
Enrollment ID: I20160930000388
Provider NameAnna Seay
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1821435207
PECOS PAC ID: 8224269253
Enrollment ID: I20161020001611
Provider NameMolly Del Santo
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1588923395
PECOS PAC ID: 0749428092
Enrollment ID: I20170125002053
Provider NameRahel Aziz
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1902354277
PECOS PAC ID: 7810273976
Enrollment ID: I20170404002575
Provider NameAnthony V Nguyen
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1396157194
PECOS PAC ID: 8628391018
Enrollment ID: I20171101000824
Provider NameRhonda Mcgrew
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962920298
PECOS PAC ID: 9032477047
Enrollment ID: I20171221000565
Provider NameLeah Marie Casarez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720571805
PECOS PAC ID: 8921272592
Enrollment ID: I20180628001489
Provider NameAndrea Mayfield
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1184131849
PECOS PAC ID: 2860749892
Enrollment ID: I20180723002572
Provider NameElizabeth B Stewart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790272250
PECOS PAC ID: 8325398829
Enrollment ID: I20180904002634
Provider NameAmanda Lord
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013414630
PECOS PAC ID: 7810247053
Enrollment ID: I20180907002635
Provider NameLindsey Ward Beakley
Provider TypePractitioner - Surgical Oncology
Provider IdentifiersNPI Number: 1396044277
PECOS PAC ID: 9931452067
Enrollment ID: I20181018003257
Provider NameStephanie Marie Bender
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1962897454
PECOS PAC ID: 4284940529
Enrollment ID: I20181022002187
Provider NameLatasha Dawn Henry
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1326304171
PECOS PAC ID: 9234368036
Enrollment ID: I20190202000135
Provider NameKristen Marie Butler
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1720307416
PECOS PAC ID: 1951547421
Enrollment ID: I20190312000081
Provider NameAlexis C Allen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659764157
PECOS PAC ID: 1850605023
Enrollment ID: I20190501003482
Provider NameLee Anthony Dinning
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1770945628
PECOS PAC ID: 2163719378
Enrollment ID: I20191004000433
Provider NameAli Riza Nazari
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1104278829
PECOS PAC ID: 0446544696
Enrollment ID: I20191011000821
Provider NameAmanda Kelley Arnold
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1144869595
PECOS PAC ID: 0143658575
Enrollment ID: I20200319000257
Provider NameClay Agee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194201277
PECOS PAC ID: 3476890823
Enrollment ID: I20200622001705
Provider NameYamima Bashir
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1932620887
PECOS PAC ID: 5698191179
Enrollment ID: I20200813003643
Provider NameAkshaya Kambhatla
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1427431667
PECOS PAC ID: 6608124078
Enrollment ID: I20200908000774
Provider NameHillary Macall Whitfield
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922604677
PECOS PAC ID: 5496168601
Enrollment ID: I20210107001831
Provider NameLeslie M Sharbel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467059295
PECOS PAC ID: 1254744212
Enrollment ID: I20210112000895
Provider NamePaige Marion Mclain
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770177545
PECOS PAC ID: 2264848142
Enrollment ID: I20210302001246
Provider NameMichelle Krause
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427657956
PECOS PAC ID: 0941600498
Enrollment ID: I20210621001829
Provider NameLee Wagner
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316442361
PECOS PAC ID: 5597016881
Enrollment ID: I20210709001506
Provider NameDavid Schexnayder
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1922461763
PECOS PAC ID: 4183919152
Enrollment ID: I20210721000637
Provider NameDanuel Laan
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1497162309
PECOS PAC ID: 5890912604
Enrollment ID: I20210813000902
Provider NameDeanna Kinslow
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1710493200
PECOS PAC ID: 3173929692
Enrollment ID: I20210909000915
Provider NameMadelyn Collum
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629641519
PECOS PAC ID: 7012315914
Enrollment ID: I20211007000109
Provider NameMichael Ann Harbin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750954327
PECOS PAC ID: 4183015050
Enrollment ID: I20220104000214
Provider NameMinh Pham
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932761814
PECOS PAC ID: 5092197426
Enrollment ID: I20220802002657
Provider NameDenise Lache Carroll
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730785098
PECOS PAC ID: 4385002997
Enrollment ID: I20230614000568
Provider NameValerie Elizabeth Glass
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780369140
PECOS PAC ID: 7214399443
Enrollment ID: I20230818002655
Provider NameJean Thompson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710084678
PECOS PAC ID: 3173525185
Enrollment ID: I20231030003028

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.