NPIMap

Organization Active NPI

East Alabama Heart and Vascular, LLC

Doing business as Heart and Lung Surgeons of East Alabama

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Opelika, AL
National Provider Identifier
1073120119
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
EAST ALABAMA HEART AND VASCULAR, LLC
Doing business as
Heart and Lung Surgeons of East Alabama
Practice address
2601 Village Professional Drive
Opelika, AL 36801-4784
Phone
(334) 528-5400
NPI assigned
Sep 23, 2020
Last updated
Sep 23, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
THE EAST ALABAMA HEALTHCARE AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Authorized official

Name
Samuel A Price Jr.
Title
Cfo
Phone
(334) 528-1310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU Primary

Addresses

Primary practice location

2601 Village Professional Drive
Opelika, AL 36801-4784

Mailing address

2601 Village Professional Drive
Opelika, AL 36801-4784
Phone (334) 528-5400

Other practice location 1

2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone (334) 528-5400

Other names 1

  • Heart and Lung Surgeons of East Alabama Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201116002727 AL Part B Supplier - Clinic/Group Practice 9638344708 Receives reassigned benefits from 17 practitioners
Practice locations: Opelika, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
East Alabama Heart and Vascular LLC2 organizations share this tax ID, including this one
Part of
East Alabama Medical Ce

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2129 Moonbrook Dr
Dadeville, AL 36853
Phone (256) 827-1489

729 E South St
Dadeville, AL 36853
Phone (256) 825-3420

2601 Village Professional Dr N
Opelika, AL 36801
Phone (334) 528-5959

865 Summerville Rd
Smiths Station, AL 36877
Phone (334) 528-3662

80 Herren Hill Rd
Tallassee, AL 36078
Phone (334) 283-3709

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1073120119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 VILLAGE PROFESSIONAL DRIVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368014784",
            "telephone_number": "334-528-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 VILLAGE PROFESSIONAL DRIVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368014784",
            "telephone_number": "334-528-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Pepperell Pkwy",
            "address_purpose": "LOCATION",
            "city": "Opelika",
            "state": "AL",
            "postal_code": "368015452",
            "country_code": "US",
            "telephone_number": "334-528-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST ALABAMA HEART AND VASCULAR, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE EAST ALABAMA HEALTHCARE AUTHORITY",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "334-528-1310",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart and Lung Surgeons of East Alabama",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Opelika, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.