Southeastern Pain & Rehabilitation Physicians, PC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

SOUTHEASTERN PAIN & REHABILITATION PHYSICIANS, PC

Practice address

1050 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2958

Phone

(205) 759-7246

Fax

(205) 759-7348

NPI assigned

Sep 7, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Wesley L Spruill, MDNPI 1184618969

Title

President

Phone

(205) 759-7246

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wesley L Spruill, MD

  • Interventional Pain Medicine Physician
  • Tuscaloosa, AL
  • NPI 1184618969
  Medicare reassignment Care Compare group NPD Authorized official
• Don Earl McCormick III, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Birmingham, AL
  • NPI 1811309255
  Medicare reassignment Care Compare group NPD
• Richard Charles Thomason Jr., MD

  • Pain Medicine Physician
  • Tuscaloosa, AL
  • NPI 1396951596
  Medicare reassignment Care Compare group NPD
• Mallory A. Booth, PA-C

  • Medical Physician Assistant
  • Tuscaloosa, AL
  • NPI 1073960118
  Medicare reassignment Care Compare group
• Wendi Luann Brownlee, CRNP

  • Family Nurse Practitioner
  • Northport, AL
  • NPI 1285949016
  Medicare reassignment NPD
• Audra Leigh Busenlehner, M.D.

  • Family Medicine Physician
  • Northport, AL
  • NPI 1720051584
  Medicare reassignment NPD
• James Barrett Darden, MD

  • Interventional Pain Medicine Physician
  • Tuscaloosa, AL
  • NPI 1558431395
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1467446237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 934585",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311934585",
            "telephone_number": "800-897-6169",
            "fax_number": "800-897-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 RUBY TYLER PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042958",
            "telephone_number": "205-759-7246",
            "fax_number": "205-759-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN PAIN & REHABILITATION PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "SPRUILL",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-759-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529901330",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC OF AL",
            "identifier": "G111",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DA7618",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Medical, Inc.
• Southeast Physician Network, LLC
• Southeast Physician Network, P.C.
• Southeast Physician Network, P.C.
• Southeastern Hearing Services, Inc.
• Southeastern Plastic Surgery Assoc., PC
• Southeastern Plastic Surgery, LLC
• Southeastern Spine Specialists Inc
• Southern Diagnostic Laboratories, LLC
• Southern Family Markets LLC

• Pain Medicine Physician in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Pain Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.