NPIMap

Organization Active NPI

Radiology Associates of Dothan PC

  • Diagnostic Radiology Physician
  • Dothan, AL
National Provider Identifier
1083697718
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY ASSOCIATES OF DOTHAN PC
Practice address
1900 Fairview Ave
Dothan, AL 36301-3008
Phone
(334) 793-9511
Fax
(334) 794-0721
NPI assigned
Nov 28, 2005
Last updated
Jan 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Authorized official

Name
William W Beckett Jr., MDNPI 1366425019
Title
President
Phone
(334) 793-9511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X NU
Diagnostic Radiology Physician 2085R0202X NU Primary
Vascular & Interventional Radiology Physician 2085R0204X NU

Addresses

Primary practice location

1900 Fairview Ave
Dothan, AL 36301-3008

Mailing address

2015 Alexander Dr
Dothan, AL 36301-3003
Phone (334) 671-1696

Other identifiers 3

IdentifierTypeStateIssuer
274277202MedicaidAL
300040735AMedicaidGA
000060028MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TX, OH, FL, GA, NJ, VA7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
O20050610000108 AL Part B Supplier - Clinic/Group Practice 2163465147 Receives reassigned benefits from 19 practitioners
Practice locations: Dothan, AL; Enterprise, AL; Eufaula, AL
O20250123001308 TX Part B Supplier - Clinic/Group Practice 2163465147 Receives reassigned benefits from 2 practitioners
Practice locations: Frisco, TX; Wolfforth, TX
O20251006000056 OH Part B Supplier - Clinic/Group Practice 2163465147 Receives reassigned benefits from 1 practitioner
Practice locations: Cincinnati, OH
O20251204004191 FL Part B Supplier - Clinic/Group Practice 2163465147 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL
O20260112000568 GA Part B Supplier - Clinic/Group Practice 2163465147 Receives reassigned benefits from 1 practitioner
Practice locations: Rome, GA
O20260311001281 NJ Part B Supplier - Clinic/Group Practice 2163465147 Receives reassigned benefits from 1 practitioner
Practice locations: Short Hills, NJ
O20260324002419 VA Part B Supplier - Clinic/Group Practice 2163465147 Receives reassigned benefits from 1 practitioner
Practice locations: Winchester, VA

National Provider Directory

National Provider Directory

Locations

1900 Fairview Ave
Dothan, AL 36301
Phone (334) 793-9511

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263513600000",
    "number": "1083697718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 ALEXANDER DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013003",
            "telephone_number": "334-671-1696",
            "fax_number": "334-794-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 FAIRVIEW AVE",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013008",
            "telephone_number": "334-793-9511",
            "fax_number": "334-794-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF DOTHAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2010-01-15",
        "status": "A",
        "authorized_official_last_name": "BECKETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-793-9511",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274277202",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300040735A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000060028",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.