Individual provider Active NPI

Anna Leigh Breedlove, PA-C

  • Surgical Physician Assistant
  • Tuscaloosa, AL
National Provider Identifier
1265185243
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
701 University Blvd E Ste 604
Tuscaloosa, AL 35401-7411
Phone
(205) 759-6925
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

701 University Blvd E Ste 604
Tuscaloosa, AL 35401-7411

Mailing address

701 University Blvd E Ste 604
Tuscaloosa, AL 35401-7411
Phone (205) 759-6925

Other practice location 1

12024 Plum Dr
Northport, AL 35475-4739
Phone (205) 535-9660

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220524001978 AL Practitioner - Physician Assistant 0547647984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

701 University Blvd E
Tuscaloosa, AL 35401-2092

809 University Blvd E
Tuscaloosa, AL 35401-2092

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Alabama Physician Associates, LLC CurrentSince Apr 1, 2022 Accepting new patients
West Alabama Physician Associates, LLC CurrentSince Apr 1, 2022 Accepting new patients
West Alabama Physician Associates, LLC Past Accepting new patients
West Alabama Physician Associates LLC Past Accepting new patients

Locations

701 University Blvd E
Ste 604
Tuscaloosa, AL 35401
Phone (205) 759-6925

3901 Greensboro Ave
Ste A
Tuscaloosa, AL 35405
Phone (205) 759-6165

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 3

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": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1265185243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 UNIVERSITY BLVD E STE 604",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017411",
            "telephone_number": "205-759-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 UNIVERSITY BLVD E STE 604",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017411",
            "telephone_number": "205-759-6925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12024 Plum Dr",
            "address_purpose": "LOCATION",
            "city": "Northport",
            "state": "AL",
            "postal_code": "354754739",
            "country_code": "US",
            "telephone_number": "205-535-9660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREEDLOVE",
        "first_name": "ANNA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.