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EDWARDS LAKE MEDICAL CENTER LLC
NPI 1043321300
Specialist in Birmingham, AL

Active since August 31, 2006CLIA 01D1010485 · Waiver
3240 EDWARDS LAKE PKWY, SUITE 204, BIRMINGHAM, AL 35235(205) 949-1414(205) 949-1415 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Edwards Lake Medical Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWARDS LAKE MEDICAL CENTER LLC (NPI 1043321300) is a healthcare organization registered as a specialist in Birmingham, Alabama and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through March 31, 2027 and lists Jacki Bailey, Billing Mgr, as its authorized official.

NPPES Registry Identity

NPI1043321300
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameEDWARDS LAKE MEDICAL CENTER LLC
Location Address3240 EDWARDS LAKE PKWY, SUITE 204Birmingham, AL 35235-3117
Mailing Address3240 Edwards Lake Pkwy, Suite 204Birmingham, AL 35235-3117 · (205) 949-1414 · Fax (205) 949-1415
Phone(205) 949-1414
Fax(205) 949-1415
Organization SubpartNo
Authorized OfficialJacki BaileyBilling Mgr · (205) 699-1632
Enumeration DateAugust 31, 2006
Last NPPES UpdateJune 20, 2024
NPPES CertifiedJune 20, 2024
✔ NPI 1043321300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in AL · 00013482
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3240 EDWARDS LAKE PKWY, Birmingham, AL 35235
Open in Google Maps ↗

Other Identifiers 1

Other1316985062AL · Individual Npi

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edwards Lake Medical Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Edwards Lake Medical Center LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Andreas Maddux, MD
Internal Medicine
NPI 1316985062
3240 EDWARDS LAKE PKWY 204
Birmingham, AL 35235
(205) 949-1414
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 01D1010485

Edwards Lake Medical Center · Birmingham, AL
Active · expires Mar 31, 2027
CLIA Number01D1010485
Laboratory TypePhysician Office
Certificate Effective DateApril 1, 2025
Certificate Expiration DateMarch 31, 2027
Laboratory DirectorAndreas T. Maddux MD
Laboratory Phone(205) 949-1414
Laboratory LocationEdwards Lake Medical Center3240 Edwards Lake Pkwy Suite 204, Birmingham, AL 35235
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edwards Lake Medical Center LLC's NPI number?

The NPI number for Edwards Lake Medical Center LLC is 1043321300. It was assigned to this organization in the NPPES registry on August 31, 2006.

Where is Edwards Lake Medical Center LLC located?

Edwards Lake Medical Center LLC is located at 3240 Edwards Lake Pkwy Suite 204, Birmingham, AL 35235. The listed phone number is (205) 949-1414.

What is Edwards Lake Medical Center LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Edwards Lake Medical Center LLC enrolled in Medicare?

Yes. Edwards Lake Medical Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Edwards Lake Medical Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Edwards Lake Medical Center LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Edwards Lake Medical Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D1010485) is associated with this NPI, valid through March 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Edwards Lake Medical Center LLC was last updated on June 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.