Individual provider Active NPI

Mary C Doyle, CRNA

  • Certified Registered Nurse Anesthetist
  • Dothan, AL
National Provider Identifier
1427019223
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1033493 Issued in AL
Practice address
4370 W Main St
Dothan, AL 36305
Phone
(334) 793-5000
Fax
(334) 615-8419
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1033493 AL Primary

Addresses

Primary practice location

4370 W Main St
Dothan, AL 36305

Mailing address

PO Box 6907
Dothan, AL 36302
Phone (334) 793-5000

Other identifiers 7

IdentifierTypeStateIssuer
051515736MedicaidAL
000497648BMedicaidGA
1771350MedicaidLA
P00122094OtherRR MEDICARE
51515736OtherALBLUE CROSS BLUE SHIELD
034385400MedicaidFL
05100519MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1033493ALMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1427019223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6907",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36302",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-793-5000",
            "fax_number": "334-615-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1033493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051515736",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000497648B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1771350",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00122094",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51515736",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034385400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05100519",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.