Individual provider Active NPI

Gary D Pugh, D.O

  • Obstetrics & Gynecology Physician
  • Huntsville, AL
National Provider Identifier
1407864945
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
DO462 Issued in AL
Practice address
101 Sivley Rd SW
Women's & Children Administration
Huntsville, AL 35801-4421
Phone
(256) 265-3880
Fax
(256) 265-3886
NPI assigned
Aug 3, 2006
Last updated
Dec 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DO462 AL Primary

Addresses

Primary practice location

101 Sivley Rd SW
Women's & Children Administration
Huntsville, AL 35801-4421

Mailing address

PO Box 2705
Huntsville, AL 35804-2705
Phone (256) 265-3880

Other identifiers 2

IdentifierTypeStateIssuer
316329YR41OtherNMMEDICARE
52921280MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160113001325 AL Practitioner - Obstetrics/Gynecology 5890789622 Reassigns benefits to 2 organizations
I20161109000876 IN Practitioner - Obstetrics/Gynecology 5890789622 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO462ALMDObstetrics & Gynecology Physician
462ALMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Group CurrentSince Jun 1, 2016 Accepting new patients
Obhg Indiana, PC Obstetrics & Gynecology CurrentSince Oct 8, 2016 Accepting new patients
Obhg Alabama, P.C. Obstetrics & Gynecology CurrentSince Nov 5, 2018 Accepting new patients

Locations

2010 Medical Center Dr
Homewood, AL 35209
Phone (205) 877-1930

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1407864945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042705",
            "telephone_number": "256-265-3880",
            "fax_number": "256-265-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "address_2": "WOMEN'S & CHILDREN ADMINISTRATION",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014421",
            "telephone_number": "256-265-3880",
            "fax_number": "256-265-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "GARY",
        "middle_name": "D",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "DO462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "316329YR41",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52921280",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.