Active NPI
Cody McIntyre, CRNA
- Certified Registered Nurse Anesthetist
- Dothan, AL
National Provider Identifier
1104539253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 145126
- Practice address
- 503 Dunleith Blvd
Dothan, AL 36303-2949 - Phone
- (432) 425-3245
- NPI assigned
- Jan 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 145126 | AL | Primary |
Addresses
Primary practice location
503 Dunleith Blvd
Dothan, AL 36303-2949
Mailing address
503 Dunleith Blvd
Dothan, AL 36303-2949
Phone (432) 425-3245
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Florida State University College of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 793-8087
Hospital & facility affiliations
- Southeast Health Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145126 | AL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Houston County Healthcare Authority | Current | Accepting new patients | |
| Houston County Healthcare Authority | Current | Accepting new patients |
Locations
1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Enterprise, AL
- NPI 1619026606
-
- Internal Medicine Physician
- Dothan, AL
- NPI 1538597349
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dothan, AL
- NPI 1164403861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672790400000",
"number": "1104539253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "503 DUNLEITH BLVD",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363032949",
"telephone_number": "432-425-3245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 DUNLEITH BLVD",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363032949",
"telephone_number": "432-425-3245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTYRE",
"first_name": "CODY",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-04",
"last_updated": "2023-01-04",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AL",
"license": "145126",
"primary": true
}
],
"identifiers": [],
"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 4, 2023; 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.