Individual provider Active NPI

Manuel Escobar, NP

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1023547833
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-115154 Issued in AL
Practice address
454 Taylor Rd
Montgomery, AL 36117-3563
Phone
(334) 613-9000
Fax
(334) 532-0056
NPI assigned
Jun 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-115154 AL Primary

Addresses

Primary practice location

454 Taylor Rd
Montgomery, AL 36117-3563

Mailing address

454 Taylor Rd
Montgomery, AL 36117-3563
Phone (334) 613-9000

Other identifiers 1

IdentifierTypeStateIssuer
1-115154OtherALLICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170830000689 AL Practitioner - Nurse Practitioner 6608149414 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Nov 15, 2021 Accepting new patients
Southern Orthopaedic Surgeons, LLC CurrentSince Jun 24, 2017 Accepting new patients
Southern Orthopaedic Surgeons, LLC CurrentSince Jun 24, 2017 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Nov 15, 2021 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients

Locations

7449 Eastchase Pkwy
Montgomery, AL 36117
Phone (334) 747-4030

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

454 Taylor Rd
Montgomery, AL 36117

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

668 McQueen Smith Rd N
Prattville, AL 36066

Organizations & group practices 5

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": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023547833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173563",
            "telephone_number": "334-613-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173563",
            "telephone_number": "334-613-9000",
            "fax_number": "334-532-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBAR",
        "first_name": "MANUEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-115154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1-115154",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.