Individual provider Active NPI

Stephen Blakely Ezzell, CRNA

  • Certified Registered Nurse Anesthetist
  • Dothan, AL
National Provider Identifier
1164474623
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1083935 Issued in AL
Practice address
4370 W Main St
Dothan, AL 36305-1056
Phone
(334) 793-5000
Fax
(334) 615-8419
NPI assigned
May 16, 2006
Last updated
Jun 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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 1083935 AL Primary

Addresses

Primary practice location

4370 W Main St
Dothan, AL 36305-1056

Mailing address

PO Box 6907
Dothan, AL 36302
Phone (334) 793-5000

Other practice location 1

820 W Washington St
Eufaula, AL 36027-1899
Phone (334) 688-7000

Other identifiers 2

IdentifierTypeStateIssuer
051522300OtherALBLUE CROSS
051554687MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040517000793 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456341809 Reassigns benefits to 8 organizations
I20240513002848 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456341809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gut PCGroup PAC ID 3375589799, 53 clinicians

Practice addresses (Care Compare)

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 793-8087

265 Medical Park Boulevard
Dothan, AL 36301
Phone (334) 305-0112

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1083935ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan Anesthesiology Associates PC CurrentSince May 1, 2013 Accepting new patients
Gut PC CurrentSince Feb 17, 2025 Accepting new patients
The Health Care Authority of the City of Eufaula CurrentSince Aug 1, 2025 Accepting new patients
Dale Medical Center CurrentSince Jun 28, 2022 Accepting new patients
Northwest Florida Healthcare, Inc Current Accepting new patients
Southern Alabama Surgery Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 11, 2014 Accepting new patients
Dale Medical Center Current Accepting new patients
Houston County Healthcare Authority CurrentSince Jun 1, 2019 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Northwest Florida Healthcare, Inc CurrentSince Apr 16, 2024 Accepting new patients
Dale Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jun 28, 2022 Accepting new patients
The Health Care Authority of the City of Eufaula Current Accepting new patients
Gut PC Nurse Anesthetist, Certified Registered CurrentSince Feb 17, 2025 Accepting new patients
The Health Care Authority of the City of Eufaula CurrentSince Aug 1, 2025 Accepting new patients
Northwest Florida Healthcare, Inc. CurrentSince Apr 16, 2024 Accepting new patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

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

265 Medical Park Blvd
Dothan, AL 36301
Phone (334) 305-0112

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

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

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

480 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 792-6933

820 W Washington St
Eufaula, AL 36027
Phone (334) 687-5761

126 Hospital Ave
Ozark, AL 36360
Phone (334) 445-4803

1360 Brickyard Rd
Chipley, FL 32428
Phone (850) 415-8300

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 18

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1164474623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6907",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36302",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051056",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Eufaula",
            "state": "AL",
            "postal_code": "360271899",
            "country_code": "US",
            "telephone_number": "334-688-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZZELL",
        "first_name": "STEPHEN",
        "middle_name": "BLAKELY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1083935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051522300",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051554687",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.