Individual provider Active NPI

Joel C Neal, CRNA

  • Certified Registered Nurse Anesthetist
  • Dothan, AL
National Provider Identifier
1194789123
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1068485 Issued in AL
Practice address
4370 W Main St
Dothan, AL 36305
Phone
(334) 793-5000
Fax
(334) 615-8419
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1068485 AL Primary
Certified Registered Nurse Anesthetist 367500000X 3364432 FL

Addresses

Primary practice location

4370 W Main St
Dothan, AL 36305

Mailing address

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

Other identifiers 8

IdentifierTypeStateIssuer
000933919BMedicaidGA
2000640OtherUNITED HEALTHCARE
51515915OtherALBLUE CROSS BLUE SHIELD
051515915MedicaidAL
07152861MedicaidMS
304213800MedicaidFL
P00122076OtherRR MEDICARE
1771368MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070927000881 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850333972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

6002 Berryhill Rd
Milton, FL 32570-5062
Phone (850) 626-7762

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1068485ALMDCertified Registered Nurse Anesthetist
3364432FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2015 Accepting new patients
Anesthesia Health Care Partners of Florida Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
The Anesthesia Group, P.a. Past Accepting new patients
QHG of Enterprise Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

Organizations & group practices 4

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": "1183852800000",
    "number": "1194789123",
    "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": "36305",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "JOEL",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1068485",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "3364432",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000933919B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2000640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51515915",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051515915",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07152861",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304213800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00122076",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1771368",
            "state": "LA"
        }
    ],
    "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 Jul 8, 2007; 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.