NPIMap

Organization Active NPI

West Alabama Physician Associates LLC

Doing business as Fayette General Surgery

  • Surgery Physician
  • Fayette, AL
National Provider Identifier
1417362807
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
WEST ALABAMA PHYSICIAN ASSOCIATES LLC
Doing business as
Fayette General Surgery
Practice address
1716 Temple Ave N
Suite 1 & 2
Fayette, AL 35555-1309
Phone
(205) 932-1280
Fax
(205) 932-1260
NPI assigned
Jun 25, 2014
Last updated
Jun 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Authorized official

Name
Mr. Jeff D Caples
Title
Member Representative
Phone
(205) 333-4657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

1716 Temple Ave N
Suite 1 & 2
Fayette, AL 35555-1309

Mailing address

1716 Temple Ave N
Suite 1 & 2
Fayette, AL 35555-1309
Phone (205) 932-1280

Other names 1

  • Fayette General Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080918000595 AL Part B Supplier - Clinic/Group Practice 3476620311 Receives reassigned benefits from 43 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fayette, AL; Tuscaloosa, AL

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
DCH Workforce Health Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1716 Temple Ave N
Ste 1
Fayette, AL 35555
Phone (205) 932-5966

Practitioners & affiliated clinicians

Practitioners 2

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": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1417362807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 TEMPLE AVE N",
            "address_2": "SUITE 1 & 2",
            "city": "FAYETTE",
            "state": "AL",
            "postal_code": "355551309",
            "telephone_number": "205-932-1280",
            "fax_number": "205-932-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 TEMPLE AVE N",
            "address_2": "SUITE 1 & 2",
            "city": "FAYETTE",
            "state": "AL",
            "postal_code": "355551309",
            "telephone_number": "205-932-1280",
            "fax_number": "205-932-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST ALABAMA PHYSICIAN ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "CAPLES",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER REPRESENTATIVE",
        "authorized_official_telephone_number": "205-333-4657",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayette General Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayette, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; 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.