NPIMap

Organization Active NPI

Eastern Shore Anesthesia PC

  • Anesthesiology Physician
  • Fairhope, AL
National Provider Identifier
1467404558
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
EASTERN SHORE ANESTHESIA PC
Practice address
750 Morphy Ave
Fairhope, AL 36532-1812
Phone
(251) 990-1109
Fax
(251) 990-1112
NPI assigned
May 17, 2006
Last updated
Apr 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Timothy W Houseman, MDNPI 1366495996
Title
President
Phone
(256) 764-9697

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

750 Morphy Ave
Fairhope, AL 36532-1812

Mailing address

PO Box 661495
Birmingham, AL 35266-1495
Phone (205) 979-5882

Other practice location 1

27961 US Highway 98
Daphne, AL 36526-4702
Phone (251) 990-1109

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040319001132 AL Part B Supplier - Clinic/Group Practice 9830089978 Receives reassigned benefits from 72 practitioners
Practice locations: Fairhope, AL; Daphne, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 72

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 72

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1467404558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661495",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352661495",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MORPHY AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321812",
            "telephone_number": "251-990-1109",
            "fax_number": "251-990-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27961 US Highway 98",
            "address_purpose": "LOCATION",
            "city": "Daphne",
            "state": "AL",
            "postal_code": "365264702",
            "country_code": "US",
            "telephone_number": "251-990-1109",
            "fax_number": "251-990-1112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTERN SHORE ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "HOUSEMAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-764-9697",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.