Individual provider Active NPI

Eric C Lund, MD

  • Diagnostic Radiology Physician
  • Dothan, AL
National Provider Identifier
1003899659
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
13554 Issued in AL
Practice address
1900 Fairview Ave
Dothan, AL 36301-3008
Phone
(334) 793-9511
Fax
(334) 794-0721
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 13554 AL Primary
Vascular & Interventional Radiology Physician 2085R0204X 13554 AL

Addresses

Primary practice location

1900 Fairview Ave
Dothan, AL 36301-3008

Mailing address

2015 Alexander Dr
Dothan, AL 36301-3003
Phone (337) 671-1696

Other identifiers 8

IdentifierTypeStateIssuer
009998815MedicaidAL
261081700MedicaidFL
000059507MedicaidAL
000433793SMedicaidGA
009941466MedicaidAL
000433793RMedicaidGA
009998825MedicaidAL
009998805MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060106000371 AL Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 2668495516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89 of 100Reported as group
Quality
95
Improvement activities
40
Cost
72.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13554ALMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Dothan PC Diagnostic Radiology CurrentSince Mar 10, 2000 Accepting new patients
Northwest Diagnostic Imaging, Inc Diagnostic Radiology Past Accepting new patients

Locations

1900 Fairview Ave
Dothan, AL 36301
Phone (334) 793-9511

2015 Alexander Dr
Dothan, AL 36301
Phone (334) 671-1696

Interoperability endpoints

  • Direct secure messaging: elund11940@southeasthealth.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1003899659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 ALEXANDER DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013003",
            "telephone_number": "337-671-1696",
            "fax_number": "334-794-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 FAIRVIEW AVE",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013008",
            "telephone_number": "334-793-9511",
            "fax_number": "334-794-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUND",
        "first_name": "ERIC",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "13554",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AL",
            "license": "13554",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009998815",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261081700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059507",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000433793S",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009941466",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000433793R",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009998825",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009998805",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.