Individual provider Active NPI

Spencer Evenhuis, D.O.

  • Anesthesiology Physician
  • Huntsville, AL
National Provider Identifier
1144510595
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
13458 Issued in CA
Practice address
721 Madison St SE
Huntsville, AL 35801-4408
Phone
(256) 880-6711
Fax
(256) 880-6712
NPI assigned
Apr 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 13458 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X AL05483 AL

Addresses

Primary practice location

721 Madison St SE
Huntsville, AL 35801-4408

Mailing address

PO Box 288
Huntsville, AL 35804-0288
Phone (256) 880-6711

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141202000343 AL Practitioner - Anesthesiology 1254578909 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants Medical Group PCGroup PAC ID 8628975935, 15 clinicians

Practice addresses (Care Compare)

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 793-8111

Hospital & facility affiliations

  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001
  • Flowers Hospital Hospital, Dothan, AL, CCN 010055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
13458CAMDChiropractor
AL05483ALMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Alabama Surgery Center LLC Anesthesiology CurrentSince Jul 24, 2019 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Mar 1, 2016 Accepting new patients
Anesthesia Consultants Medical Group PC Anesthesiology CurrentSince Aug 1, 2017 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

2800 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-3411

1118 Ross Clark Cir
Ste 700
Dothan, AL 36301
Phone (334) 793-5105

2800 Ross Clark Cir
Ste 3
Dothan, AL 36301
Phone (334) 793-3411

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1144510595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 288",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358040288",
            "telephone_number": "256-880-6711",
            "fax_number": "256-880-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 MADISON ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014408",
            "telephone_number": "256-880-6711",
            "fax_number": "256-880-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVENHUIS",
        "first_name": "SPENCER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "13458",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "AL05483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.