Mtn Lake Urology PC
NPI 1801050364ActiveOrganization· Specialist· Scottsboro, AL
Specialist in Scottsboro, Alabama, registered in NPPES in July 2008. The authorized official on file is Sherry Gross, Office Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1801050364 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 14, 2008 |
| Last updated in NPPES | Mar 21, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | 17993 | AL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AL) |
|---|
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