Great State Alabama – Dermatology Physician, NPI 1124757588

Great State Alabama is a healthcare provider. based in Tuscaloosa, Alabama. specializing in Dermatology Physician. The NPI Number for Great State Alabama is 1124757588

Main info

Organization
Name
Great State Alabama
NPI
1124757588
Phone
(205) 509-9055
Address
4960 RICE MINE RD NE STE 30A
Authorized Official
DANIEL SPARKMAN EXECUTIVE DIRECTOR
Enumeration Date
9 June 2022
Last Update Date
9 June 2022

Contacts

Other Endpoint
https://26162.portal.athenahealth.com/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness90
Years active:4State licenses:0Updated within 12 months

Provider Addresses for Great State Alabama

  • 4960 RICE MINE RD NE STE 30A

    TUSCALOOSA, AL 354063136

    Phone: (205) 509-9055

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35406)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Great State Alabama?
Great State Alabama — NPI 1124757588 — is the standard way to identify this listing.
Is Great State Alabama listed as active for patients and plans?
The listing shows Great State Alabama as active in the NPI system.
What healthcare role does Great State Alabama hold?
Scheduling teams often label Great State Alabama under Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where is Great State Alabama based?
Great State Alabama is tied to Tuscaloosa, Alabama in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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