NPIMap

Organization Active NPI

Physynergy, LLC

  • Anesthesiology Physician
  • Huntsville, AL
National Provider Identifier
1134465560
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PHYSYNERGY, LLC
Practice address
1 Hospital Dr SW
Huntsville, AL 35801-6455
Phone
(256) 429-5071
Fax
(256) 429-4674
NPI assigned
Dec 12, 2012
Last updated
Dec 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Timothy Killen Adams Jr., MD
Title
President
Phone
(256) 429-5071

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AL
Anesthesiologist Assistant 367H00000X AL
Anesthesiology Physician 207L00000X AL Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X AL

Addresses

Primary practice location

1 Hospital Dr SW
Huntsville, AL 35801-6455

Mailing address

PO Box 52404
Lafayette, LA 70505-2404
Phone (706) 860-2701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130222000456 AL Part B Supplier - Clinic/Group Practice 6204081292 Receives reassigned benefits from 217 practitioners
4 other NPIs on this enrollment
Practice locations: Huntsville, AL; Madison, AL; Mobile, AL

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Physynergy LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 223

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 223

NPI Registry JSON

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1134465560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52404",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052404",
            "telephone_number": "706-860-2701",
            "fax_number": "706-860-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016455",
            "telephone_number": "256-429-5071",
            "fax_number": "256-429-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSYNERGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "KILLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-429-5071",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.