NPIMap

Organization Active NPI

Andalusia Physician Practices LLC

Doing business as Andalusia Neurology

  • Neurology Physician
  • Andalusia, AL
National Provider Identifier
1437202009
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
27742 Issued in AL
Legal business name
ANDALUSIA PHYSICIAN PRACTICES LLC
Doing business as
Andalusia Neurology
Practice address
109 Medical Park Dr
Suite a
Andalusia, AL 36420-5323
Phone
(334) 222-2332
Fax
(334) 222-2475
NPI assigned
Jan 18, 2007
Last updated
Feb 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Kathy Teague
Title
Vice President, Corporate Secretary
Phone
(629) 253-5121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 27742 AL Primary

Addresses

Primary practice location

109 Medical Park Dr
Suite a
Andalusia, AL 36420-5323

Mailing address

PO Box 28
Andalusia, AL 36420-1200
Phone (334) 222-2332

Other names 1

  • Andalusia Neurology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070425000603 AL Part B Supplier - Clinic/Group Practice 7315043007 Receives reassigned benefits from 47 practitioners
3 other NPIs on this enrollment
Practice locations: Andalusia, AL; Opp, AL; Evergreen, AL; Brewton, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Andalusia Family Healthcare4 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.

Practitioners & affiliated clinicians

Practitioners 50

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 50

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1437202009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364201200",
            "telephone_number": "334-222-2332",
            "fax_number": "334-222-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MEDICAL PARK DR",
            "address_2": "SUITE A",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364205323",
            "telephone_number": "334-222-2332",
            "fax_number": "334-222-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDALUSIA PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "VICE PRESIDENT, CORPORATE SECRETARY",
        "authorized_official_telephone_number": "629-253-5121"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": "27742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andalusia Neurology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Andalusia Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Andalusia, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.