Individual provider Active NPI

Justin Casey, CRNP

  • Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1053549063
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1101477 Issued in AL
Practice address
1118 Ross Clark Cir
Suite 303
Dothan, AL 36301-3001
Phone
(334) 794-3192
Fax
(877) 553-0033
NPI assigned
Jun 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1101477 AL Primary

Addresses

Primary practice location

1118 Ross Clark Cir
Suite 303
Dothan, AL 36301-3001

Mailing address

1118 Ross Clark Cir
Suite 303
Dothan, AL 36301-3001
Phone (334) 794-3192

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
I20100127000669 AL Practitioner - Nurse Practitioner 6204978349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Clinic, P.C.Group PAC ID 5991722076, 8 clinicians

Practice addresses (Care Compare)

1118 Ross Clark Cir
Suite 303
Dothan, AL 36301-3002
Phone (334) 794-3192

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1101477ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Nurse Practitioner CurrentSince Sep 1, 2025 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Southeast Alabama Medical Center Employee Pharmacy Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1118 Ross Clark Cir
Ste 303
Dothan, AL 36301
Phone (334) 794-3192

1118 Ross Clark Cir
Ste 403
Dothan, AL 36301
Phone (334) 793-5672

201 Doctors Dr
Dothan, AL 36301
Phone (334) 794-6611

1806 Fairview Ave
Dothan, AL 36301
Phone (334) 677-5986

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

Interoperability endpoints

  • Direct secure messaging: justin.casey.1@3134.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3134/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1053549063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 303",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-794-3192",
            "fax_number": "877-553-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 303",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-794-3192",
            "fax_number": "877-553-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1101477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.