NPIMap

Organization Active NPI

Tuscaloosa Ear Nose & Throat Center PC

  • Otolaryngology Physician
  • Tuscaloosa, AL
National Provider Identifier
1407914245
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
3702 Issued in AL
Legal business name
TUSCALOOSA EAR NOSE & THROAT CENTER PC
Practice address
1300 McFarland Blvd NE
Suite 150
Tuscaloosa, AL 35406-2252
Phone
(205) 758-9041
Fax
(205) 345-8328
NPI assigned
Dec 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Dr. Carlisle R Stephenson III, M.D.NPI 1780612564
Title
Partner-Physician
Phone
(205) 758-9041

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
Otolaryngology Physician 207Y00000X 3702 AL Primary

Addresses

Primary practice location

1300 McFarland Blvd NE
Suite 150
Tuscaloosa, AL 35406-2252

Mailing address

1300 McFarland Blvd NE
Suite 150
Tuscaloosa, AL 35406-2252
Phone (205) 758-9041

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060105000743 AL Part B Supplier - Clinic/Group Practice 0648293514 Receives reassigned benefits from 13 practitioners
Practice locations: Tuscaloosa, AL

National Provider Directory

National Provider Directory

Locations

1300 McFarland Blvd NE
Ste 150
Tuscaloosa, AL 35406
Phone (205) 758-9041

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407914245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MCFARLAND BLVD NE",
            "address_2": "SUITE 150",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062252",
            "telephone_number": "205-758-9041",
            "fax_number": "205-345-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MCFARLAND BLVD NE",
            "address_2": "SUITE 150",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062252",
            "telephone_number": "205-758-9041",
            "fax_number": "205-345-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSCALOOSA EAR NOSE & THROAT CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEPHENSON",
        "authorized_official_first_name": "CARLISLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER-PHYSICIAN",
        "authorized_official_telephone_number": "205-758-9041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "3702",
            "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 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.