Individual provider Active NPI

Anthony Fazal Houssain, D.C.

  • Chiropractor
  • Madison, AL
National Provider Identifier
1457323347
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1995 Issued in AL
Practice address
12205 County Line Rd
Suite D
Madison, AL 35758-7719
Phone
(256) 461-7775
Fax
(256) 461-7756
NPI assigned
Feb 3, 2006
Last updated
May 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1995 AL Primary
Rehabilitation Chiropractor 111NR0400X 1995 AL

Addresses

Primary practice location

12205 County Line Rd
Suite D
Madison, AL 35758-7719

Mailing address

12205 County Line Rd
Suite D
Madison, AL 35758-7719
Phone (256) 461-7775

Other identifiers 3

IdentifierTypeStateIssuer
051505583OtherALBLUE CROSS BLUE SHIELD
0005775803OtherAETNA
374479800OtherUS DEPT OF LABOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101230000064 AL Practitioner - Chiropractic 0042266512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spinecare Inc.Group PAC ID 1153377627, 2 clinicians

Practice addresses (Care Compare)

11743 County Line Rd
Suite a
Madison, AL 35758-3301
Phone (256) 461-7775

12205 County Line Rd
D
Madison, AL 35758-7719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Spinecare Inc Chiropractor CurrentSince Jan 1, 2002 Accepting new patients

Locations

4205 Balmoral Dr SW
Ste 202
Huntsville, AL 35801
Phone (256) 461-7775

12205 County Line Rd
Ste D
Madison, AL 35758
Phone (256) 461-7775

Organizations & group practices 1

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1457323347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12205 COUNTY LINE RD",
            "address_2": "SUITE D",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357587719",
            "telephone_number": "256-461-7775",
            "fax_number": "256-461-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12205 COUNTY LINE RD",
            "address_2": "SUITE D",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357587719",
            "telephone_number": "256-461-7775",
            "fax_number": "256-461-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSSAIN",
        "first_name": "ANTHONY",
        "middle_name": "FAZAL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1995",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AL",
            "license": "1995",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051505583",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005775803",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "374479800",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.