Individual provider Active NPI

Anna Reid Tindle, CRNP

  • Nurse Practitioner
  • Fairhope, AL
National Provider Identifier
1124501440
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-092992 Issued in AL
Practice address
188 Hospital Dr Ste 100
Fairhope, AL 36532-2038
Phone
(251) 607-9797
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1-092992 AL
Nurse Practitioner 363L00000X 1-092992 AL Primary

Addresses

Primary practice location

188 Hospital Dr Ste 100
Fairhope, AL 36532-2038

Mailing address

6701 Airport Blvd Ste D330
Mobile, AL 36608-6758
Phone (251) 607-9797

Other practice location 1

1721 N McKenzie St
Foley, AL 36535-2249
Phone (251) 607-9797

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260305000015 AL Order and Referring Only - Nurse Practitioner 2365794138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-092992ALMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1124501440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD STE D330",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086758",
            "telephone_number": "251-607-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL DR STE 100",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322038",
            "telephone_number": "251-607-9797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 N McKenzie St",
            "address_purpose": "LOCATION",
            "city": "Foley",
            "state": "AL",
            "postal_code": "365352249",
            "country_code": "US",
            "telephone_number": "251-607-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TINDLE",
        "first_name": "ANNA",
        "middle_name": "REID",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "1-092992",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-092992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.