Organization Active NPI

Central Alabama ENT Associates

  • Otolaryngology Physician
  • Montgomery, AL
National Provider Identifier
1124108535
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CENTRAL ALABAMA ENT ASSOCIATES
Practice address
6980 Winton Blount Blvd
Montgomery, AL 36117-3556
Phone
(334) 277-0484
Fax
(334) 272-8877
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Authorized official

Name
Wallace Carroll Vaughan Jr., M.D.NPI 1104906510
Title
President
Phone
(334) 277-0484

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

6980 Winton Blount Blvd
Montgomery, AL 36117-3556

Mailing address

6980 Winton Blount Blvd
Montgomery, AL 36117-3556
Phone (334) 277-0484

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060112000131 AL Part B Supplier - Clinic/Group Practice 3870516180 Receives reassigned benefits from 3 practitioners
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Locations

6980 Winton Blount Blvd
Montgomery, AL 36117
Phone (334) 277-0484

2163 Normandie Dr
Montgomery, AL 36111
Phone (334) 284-1870

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1124108535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6980 WINTON BLOUNT BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173556",
            "telephone_number": "334-277-0484",
            "fax_number": "334-272-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6980 WINTON BLOUNT BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173556",
            "telephone_number": "334-277-0484",
            "fax_number": "334-272-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ALABAMA ENT ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "CARROLL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-277-0484",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; 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.