NPIMap

Organization Active NPI

Gardendale Surgical Associates

  • Anesthesiology Physician
  • Gardendale, AL
National Provider Identifier
1235541418
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GARDENDALE SURGICAL ASSOCIATES
Practice address
2213 Decatur Hwy
Gardendale, AL 35071-2301
Phone
(205) 418-6021
NPI assigned
May 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Authorized official

Name
Deirdre Odom
Title
Manager
Phone
(334) 396-6930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

2213 Decatur Hwy
Gardendale, AL 35071-2301

Mailing address

PO Box 235022
Montgomery, AL 36123-5022
Phone (334) 386-2051

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400716800000",
    "number": "1235541418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235022",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235022",
            "telephone_number": "334-386-2051",
            "fax_number": "334-481-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 DECATUR HWY",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712301",
            "telephone_number": "205-418-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDENDALE SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "334-396-6930"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardendale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.