Individual provider Active NPI

Tami B Caldwell, CRNP

  • Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1457427858
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1078442 Issued in AL
Practice address
480 Honeysuckle Rd
Dothan, AL 36305
Phone
(334) 836-1212
Fax
(334) 836-1888
NPI assigned
Nov 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1078442 AL Primary

Addresses

Primary practice location

480 Honeysuckle Rd
Dothan, AL 36305

Mailing address

480 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 836-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040416000487 AL Practitioner - Nurse Practitioner 4284629569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gut PCGroup PAC ID 3375589799, 53 clinicians

Practice addresses (Care Compare)

480 Honeysuckle Rd
Dothan, AL 36305-1156
Phone (334) 836-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1078442ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gut PC CurrentSince Jun 20, 2012 Accepting new patients
Gut PC CurrentSince Jun 20, 2012 Accepting new patients

Locations

265 Medical Park Blvd
Dothan, AL 36301
Phone (334) 305-0112

480 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 792-6933

Organizations & group practices 2

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457427858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 HONEYSUCKLE RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-836-1212",
            "fax_number": "334-836-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 HONEYSUCKLE RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-836-1212",
            "fax_number": "334-836-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "TAMI",
        "middle_name": "B",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1078442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.