Individual provider Active NPI

Lee Headley Loftin, MD

  • Otolaryngology Physician
  • Tuscaloosa, AL
National Provider Identifier
1063443745
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
12887 Issued in AL
Practice address
1300 McFarland Blvd NE
Ste 150
Tuscaloosa, AL 35406-2283
Phone
(205) 758-9041
Fax
(205) 345-8328
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 12887 AL Primary

Addresses

Primary practice location

1300 McFarland Blvd NE
Ste 150
Tuscaloosa, AL 35406-2283

Mailing address

1300 McFarland Blvd NE
Ste 150
Tuscaloosa, AL 35406-2283
Phone (205) 758-9041

Other identifiers 2

IdentifierTypeStateIssuer
000083830MedicaidAL
051083830OtherALBLUE CROSS BLUE SHIELD

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
I20070404000494 AL Practitioner - Otolaryngology 4688778392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Alabama School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tombigbee Healthcare AuthorityGroup PAC ID 6709873235, 41 clinicians
Tuscaloosa Ear Nose and Throat Center PCGroup PAC ID 0648293514, 9 clinicians

Practice addresses (Care Compare)

105 US Hwy 80 E
Suite 230
Demopolis, AL 36732-3605
Phone (334) 287-2840

1300 McFarland Blvd NE
Suite 150
Tuscaloosa, AL 35406-2283
Phone (205) 758-9041

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12887ALMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tombigbee Healthcare Authority CurrentSince Sep 23, 2021 Accepting new patients
Tombigbee Healthcare Authority CurrentSince Sep 23, 2021 Accepting new patients

Locations

105 US Highway 80 E
Ste 230
Demopolis, AL 36732
Phone (334) 287-2840

105 US Highway 80 E
Demopolis, AL 36732
Phone (334) 287-2669

Organizations & group practices 3

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 3

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1063443745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MCFARLAND BLVD NE",
            "address_2": "STE 150",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062283",
            "telephone_number": "205-758-9041",
            "fax_number": "205-345-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MCFARLAND BLVD NE",
            "address_2": "STE 150",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062283",
            "telephone_number": "205-758-9041",
            "fax_number": "205-345-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFTIN",
        "first_name": "LEE",
        "middle_name": "HEADLEY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "12887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000083830",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051083830",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.