NPIMap

Organization Active NPI

Northport - Crna

  • Certified Registered Nurse Anesthetist
  • Northport, AL
National Provider Identifier
1265734271
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
NORTHPORT - CRNA
Practice address
2700 Hospital Dr
Northport, AL 35476-3360
Phone
(205) 333-4500
NPI assigned
Nov 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Authorized official

Name
David Herman
Title
VP Finance
Phone
(205) 759-7297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

2700 Hospital Dr
Northport, AL 35476-3360

Mailing address

PO Box 661495
Birmingham, AL 35266-1495
Phone (205) 979-5882

Other identifiers 2

IdentifierTypeStateIssuer
124766MedicaidAL
DR7373OtherALRR MCR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101230000056 AL Part B Supplier - Clinic/Group Practice 3971791286 Receives reassigned benefits from 41 practitioners
Practice locations: Northport, AL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1265734271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661495",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352661495",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 HOSPITAL DR",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763360",
            "telephone_number": "205-333-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPORT - CRNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "205-759-7297"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124766",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "DR7373",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.