Individual provider Active NPI

Kenny L. Dodd, CRNA

  • Certified Registered Nurse Anesthetist
  • Montgomery, AL
National Provider Identifier
1154358554
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-058248 Issued in AL
Practice address
1725 Pine St
Montgomery, AL 36106-1109
Phone
(334) 279-1450
Fax
(334) 395-4110
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-058248 AL Primary

Addresses

Primary practice location

1725 Pine St
Montgomery, AL 36106-1109

Mailing address

PO Box 235019
Montgomery, AL 36123-5019
Phone (334) 279-1450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050216000475 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385696509 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Shore Anesthesia, P.C.Group PAC ID 9830089978, 42 clinicians

Practice addresses (Care Compare)

750 Morphy Ave
Fairhope, AL 36532-1812
Phone (251) 990-1109

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-058248ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Anesthesia Associates, PC Nurse Anesthetist, Certified Registered CurrentSince May 15, 2010 Accepting new patients
Tombigbee Healthcare Authority CurrentSince Dec 23, 2023 Accepting new patients
Eastern Shore Anesthesia PC CurrentSince Jul 15, 2024 Accepting new patients
Tombigbee Healthcare Authority Current Accepting new patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2022 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Feb 13, 2017 Accepting new patients
Tombigbee Healthcare Authority CurrentSince Dec 23, 2023 Accepting new patients

Locations

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

619 19th St S
Birmingham, AL 35249

7101 US Highway 90
Daphne, AL 36526
Phone (251) 625-8400

27961 US Highway 98
Daphne, AL 36526
Phone (251) 435-6850

105 US Highway 80 E
Demopolis, AL 36732
Phone (334) 287-2669

411 N Section St
Fairhope, AL 36532
Phone (251) 517-5027

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1406 McFarland Blvd N
Ste 2B
Tuscaloosa, AL 35406
Phone (205) 248-0095

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

Organizations & group practices 7

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 1

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1154358554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235019",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235019",
            "telephone_number": "334-279-1450",
            "fax_number": "334-395-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PINE ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061109",
            "telephone_number": "334-279-1450",
            "fax_number": "334-395-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "KENNY",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-058248",
            "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 Jun 17, 2010; 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.

Verify at the official NPI Registry.