NPIMap

Organization Active NPI

Houston County Healthcare Authority

  • Pain Medicine (Anesthesiology) Physician
  • Dothan, AL
National Provider Identifier
1295745834
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
HOUSTON COUNTY HEALTHCARE AUTHORITY
Practice address
1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone
(334) 793-8087
Fax
(331) 793-8191
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Derek Miller, CFO
Title
Chief Financial Officer
Phone
(334) 793-8087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

1108 Ross Clark Cir
Dothan, AL 36301-3022

Mailing address

PO Box 1928
Dothan, AL 36302-1928
Phone (334) 793-8087

Other identifiers 2

IdentifierTypeStateIssuer
HOS0001HMedicaidAL
010057OtherALBCBS OF ALABAMA

Other names 1

  • Southeast Pain Management Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Houston County Hlthcare17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

102 Doctors Dr
Dothan, AL 36301
Phone (334) 793-8804

1812 E Main St
Dothan, AL 36301
Phone (334) 793-6573

1865 Honeysuckle Rd
Ste 2B
Dothan, AL 36305
Phone (334) 793-8111

1245 Westgate Pkwy
Ste 101
Dothan, AL 36303

224 Honeysuckle Rd
Dothan, AL 36305

1108 Ross Clark Cir
Ste 302
Dothan, AL 36301

1108 Ross Clark Cir
Ste 702
Dothan, AL 36301

1108 Ross Clark Cir
Ste 502
Dothan, AL 36301

1901 Melba Dr
Dothan, AL 36301
Phone 334793808752

39 Windyhill Rd
Taylor, AL 36301
Phone (334) 712-3363

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295745834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1928",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363021928",
            "telephone_number": "334-793-8087",
            "fax_number": "334-793-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-793-8087",
            "fax_number": "331-793-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON COUNTY HEALTHCARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "334-793-8087",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0001H",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "010057",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Pain Management Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.