NPIMap

Organization Active NPI

East Alabama Heart and Vascular, LLC

  • Specialist
  • Opelika, AL
National Provider Identifier
1104193069
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
EAST ALABAMA HEART AND VASCULAR, LLC
Practice address
2601 Village Professional Drive
Opelika, AL 36801-4784
Phone
(334) 528-5400
NPI assigned
Nov 21, 2011
Organization subpart
Yes
Parent organization
THE EAST ALABAMA HEALTHCARE AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 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 names 1

  • Pinnacle Cardiovascular Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111219000892 AL Part B Supplier - Clinic/Group Practice 9638344708 Receives reassigned benefits from 27 practitioners
Practice locations: Valley, AL; Union Springs, AL; Tuskegee, AL; Opelika, AL; Tallassee, AL; Roanoke, AL; Dadeville, AL; Auburn, AL…

Other NPIs with the same Medicare PAC ID 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0954951Pinnacle Cardiovascular Associates2601 Village Professional Drive, Opelika, AL 36801Certificate of waiverSep 3, 2026

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
Bethany House of East Alabama Medical Center

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

1171 Gatewood Dr
Bldg 101
Auburn, AL 36830
Phone (334) 821-2708

309 Mariarden Rd
Dadeville, AL 36853
Phone (256) 825-2303

867 Summerville Rd
Smiths Station, AL 36877
Phone (334) 291-8400

908 E Water St
Tuskegee, AL 36083
Phone (334) 727-7628

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1104193069",
    "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": [],
    "basic": {
        "organization_name": "EAST ALABAMA HEART AND VASCULAR, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE EAST ALABAMA HEALTHCARE AUTHORITY",
        "enumeration_date": "2011-11-21",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-16",
        "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": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Cardiovascular Associates",
            "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 Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.