NPIMap

Organization Active NPI

West Alabama Family Practice & Sports Medicine PC

  • Family Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1376615476
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WEST ALABAMA FAMILY PRACTICE & SPORTS MEDICINE PC
Practice address
100 Rice Mine Road Loop
Suite 206
Tuscaloosa, AL 35406-2425
Phone
(205) 339-0171
Fax
(205) 333-8681
NPI assigned
Nov 14, 2006
Last updated
Feb 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Authorized official

Name
Dr. Craig M Buettner, MDNPI 1134291263
Title
Co-Owner, Physician
Phone
(205) 339-0171

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

100 Rice Mine Road Loop
Suite 206
Tuscaloosa, AL 35406-2425

Mailing address

100 Rice Mine Road Loop
Suite 206
Tuscaloosa, AL 35406-2425
Phone (205) 339-0171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031205000620 AL Part B Supplier - Clinic/Group Practice 1254236755 Receives reassigned benefits from 10 practitioners
Practice locations: Tuscaloosa, AL
O20100930028094 AL DME Supplier - Physician - Family Practice 1254236755 Practice locations: Tuscaloosa, AL

National Provider Directory

National Provider Directory
Tax ID family
West Al F P Sports Med2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1376615476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RICE MINE ROAD LOOP",
            "address_2": "SUITE 206",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062425",
            "telephone_number": "205-339-0171",
            "fax_number": "205-333-8681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RICE MINE ROAD LOOP",
            "address_2": "SUITE 206",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062425",
            "telephone_number": "205-339-0171",
            "fax_number": "205-333-8681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST ALABAMA FAMILY PRACTICE & SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "BUETTNER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-OWNER, PHYSICIAN",
        "authorized_official_telephone_number": "205-339-0171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.