Individual provider Active NPI

William A Collignon Jr., M.D.

  • Surgery Physician
  • Florence, AL
National Provider Identifier
1174587257
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
00011307 Issued in AL
Practice address
501 East Dr Hicks Blvd
Suite a
Florence, AL 35630
Phone
(256) 383-0423
Fax
(256) 383-0922
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 00011307 AL Primary

Addresses

Primary practice location

501 East Dr Hicks Blvd
Suite a
Florence, AL 35630

Mailing address

501 E Dr Hicks Blvd
Suite a
Florence, AL 35630
Phone (256) 383-0423

Other identifiers 1

IdentifierTypeStateIssuer
051556653MedicaidAL

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
I20050922000539 AL Practitioner - General Surgery 4385678465 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Alabama School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NW Alabama Practice Management, LLCGroup PAC ID 1951434539, 3 clinicians
Helen Keller Specialty CareGroup PAC ID 9335676402, 27 clinicians

Practice addresses (Care Compare)

1100 S Jackson Hwy
Suite 101
Sheffield, AL 35660-5769
Phone (256) 772-6018

1208 S Jackson Hwy
Sheffield, AL 35660-5749
Phone (256) 386-9961

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal35
Removal of tissue11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00011307ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shoals Surgical Group LLC Surgery CurrentSince Jul 8, 2005 Accepting new patients
Helen Keller Specialty Care Surgery CurrentSince Jan 1, 2026 Accepting new patients
NW Alabama Practice Management, LLC CurrentSince Jul 1, 2020 Accepting new patients
Desselle Surgical Clinic, LLC Surgery Past Accepting new patients
Surgical Associates of the Shoals, PC Past Accepting new patients

Locations

501 E Dr Hicks Blvd
Ste A
Florence, AL 35630
Phone (256) 383-0423

1100 S Jackson Hwy
Ste 105
Sheffield, AL 35660
Phone (256) 386-4066

1100 S Jackson Hwy
Ste 101
Sheffield, AL 35660
Phone (256) 381-5955

1100 S Jackson Hwy
Ste 201
Sheffield, AL 35660
Phone (256) 320-5019

1100 S Jackson Hwy
Ste 250
Sheffield, AL 35660
Phone (256) 381-6673

1208 S Jackson Hwy
Sheffield, AL 35660
Phone (256) 386-9961

1120 S Jackson Hwy
Ste 105
Sheffield, AL 35660
Phone (256) 386-1125

Organizations & group practices 5

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1174587257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E DR HICKS BLVD",
            "address_2": "SUITE A",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "35630",
            "telephone_number": "256-383-0423",
            "fax_number": "256-383-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 EAST DR HICKS BLVD",
            "address_2": "SUITE A",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "35630",
            "telephone_number": "256-383-0423",
            "fax_number": "256-383-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIGNON",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "00011307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051556653",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.