Organization Active NPI

Montgomery Neurosurgical Associates

  • Specialist
  • Montgomery, AL
National Provider Identifier
1376535401
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MONTGOMERY NEUROSURGICAL ASSOCIATES
Practice address
1510 Forest Ave
Montgomery, AL 36106-1517
Phone
(334) 834-6422
Fax
(334) 264-5129
NPI assigned
Aug 16, 2005
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
Terry Bryant
Title
Office Manager
Phone
(334) 834-6422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X AL Primary

Addresses

Primary practice location

1510 Forest Ave
Montgomery, AL 36106-1517

Mailing address

1510 Forest Ave
Montgomery, AL 36106-1517
Phone (334) 834-6422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040515000176 AL Part B Supplier - Clinic/Group Practice 6608866207 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376535401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 FOREST AVE",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061517",
            "telephone_number": "334-834-6422",
            "fax_number": "334-264-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 FOREST AVE",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061517",
            "telephone_number": "334-834-6422",
            "fax_number": "334-264-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY NEUROSURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-834-6422"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, 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.
  • 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.