Individual provider Active NPI

William Raymond Nuessle, M.D.

  • Colon & Rectal Surgery Physician
  • Huntsville, AL
National Provider Identifier
1366493587
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
00015166 Issued in AL
Practice address
115 Manning Dr SW
Suite D101
Huntsville, AL 35801-4341
Phone
(256) 533-6070
Fax
(256) 533-9374
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 00015166 AL Primary

Addresses

Primary practice location

115 Manning Dr SW
Suite D101
Huntsville, AL 35801-4341

Mailing address

7733 Mallard Rd SW
Huntsville, AL 35802-2852
Phone (256) 426-6323

Other identifiers 1

IdentifierTypeStateIssuer
000082134MedicaidAL

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
I20100916000515 AL Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 9436199635 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00015166ALMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic for Colon & Rectal Surgery, P.a. Colon & Rectal Surgery CurrentSince Jun 1, 1990 Accepting new patients

Locations

115 Manning Dr SW
Ste D101
Huntsville, AL 35801
Phone (256) 533-6070

Organizations & group practices 1

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1366493587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7733 MALLARD RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358022852",
            "telephone_number": "256-426-6323",
            "fax_number": "256-533-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MANNING DR SW",
            "address_2": "SUITE D101",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014341",
            "telephone_number": "256-533-6070",
            "fax_number": "256-533-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUESSLE",
        "first_name": "WILLIAM",
        "middle_name": "RAYMOND",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2022-04-04",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "AL",
            "license": "00015166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000082134",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.