Individual provider Active NPI

Amy Theresa Metzger Ananth, M.D.

  • Dermatology Physician
  • Foley, AL
National Provider Identifier
1053601252
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
41753 Issued in AL
Practice address
1851 N McKenzie St Ste 104
Foley, AL 36535-4704
Phone
(251) 424-1880
Fax
(251) 424-1879
NPI assigned
Apr 10, 2011
Last updated
Oct 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD.205556 LA
Dermatology Physician 207N00000X 41753 AL Primary

Addresses

Primary practice location

1851 N McKenzie St Ste 104
Foley, AL 36535-4704

Mailing address

PO Box 746984
Atlanta, GA 30374-6984
Phone (251) 424-1880

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
I20210908001304 AL Practitioner - Dermatology 0840510632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Washington University School of Medicine, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 E Laurel Ave
Suite 101
Foley, AL 36535-2616
Phone (251) 424-1880

Merit-based Incentive Payment System (MIPS)

Final score
92.23 of 100Reported as individual
Quality
84.45
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision121
Removal of skin lesions2720
Removal or shaving of skin growth21
Skin biopsy1119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41753ALMDDermatology Physician
MD.205556LAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Camellia Dermatology, PC Dermatology CurrentSince Sep 1, 2021 Accepting new patients

Locations

1851 N McKenzie St
Ste 104
Foley, AL 36535
Phone (251) 424-1880

200 E Laurel Ave
Ste 101
Foley, AL 36535
Phone (205) 308-6647

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1302393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1053601252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746984",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746984",
            "telephone_number": "251-424-1880",
            "fax_number": "251-424-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 N MCKENZIE ST STE 104",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365354704",
            "telephone_number": "251-424-1880",
            "fax_number": "251-424-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANTH",
        "first_name": "AMY",
        "middle_name": "THERESA METZGER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-10",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD.205556",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "41753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

Verify at the official NPI Registry.