Individual provider Active NPI

Andrew A Duerr, M.D.

  • Surgery Physician
  • Enterprise, AL
National Provider Identifier
1205921509
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25234 Issued in AL
Practice address
1008 Boll Weevil Cir
Suite D
Enterprise, AL 36330-1312
Phone
(334) 347-0639
Fax
(334) 347-1021
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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 25234 AL Primary

Addresses

Primary practice location

1008 Boll Weevil Cir
Suite D
Enterprise, AL 36330-1312

Mailing address

1008 Boll Weevil Cir
Suite D
Enterprise, AL 36330-1312
Phone (334) 347-0639

Other identifiers 2

IdentifierTypeStateIssuer
51599852OtherALBLUE CROSS BLUE SHIELD OF ALABAMA
113148MedicaidAL

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
I20040227000060 AL Practitioner - Emergency MedicinePractitioner - General Surgery 2961398748 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25234ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dale Medical Center Current Accepting new patients
Southland Medical Solutions of Ozark, PL CurrentSince Jan 25, 2016 Accepting new patients
Dale Medical Center Surgery CurrentSince Aug 1, 2005 Accepting new patients
Sycamore Physicians LLC CurrentSince Dec 8, 2023 Accepting new patients
Southland Hospitalist at Ozark, PL CurrentSince Feb 1, 2020 Accepting new patients
Nes Arkansas, Inc. Past Accepting new patients
DCH Provider Services, LLC Surgery Past Accepting new patients

Locations

702 N Main St
Opp, AL 36467
Phone (334) 493-2342

218 Hospital Ave
Ste B
Ozark, AL 36360
Phone (334) 445-1025

2126 W Roy Parker Rd
Ste 202
Ozark, AL 36360
Phone (334) 443-0203

1519 Andrews Ave
Ozark, AL 36360
Phone (334) 774-7610

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

7725 W Reno Ave
Ste 150
Oklahoma City, OK 73127

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1205921509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 BOLL WEEVIL CIR",
            "address_2": "SUITE D",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363301312",
            "telephone_number": "334-347-0639",
            "fax_number": "334-347-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 BOLL WEEVIL CIR",
            "address_2": "SUITE D",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363301312",
            "telephone_number": "334-347-0639",
            "fax_number": "334-347-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUERR",
        "first_name": "ANDREW",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "25234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "51599852",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113148",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.