Individual provider Active NPI

Jeffrey H. Fadil, M.D.

  • Internal Medicine Physician
  • Abbeville, AL
National Provider Identifier
1467529495
Registry record updated Oct 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29664 Issued in AL
Practice address
1833 Co Rd 133
Abbeville, AL 36310
Phone
(251) 295-2815
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29664 AL Primary

Addresses

Primary practice location

1833 Co Rd 133
Abbeville, AL 36310

Mailing address

1833 Co Rd 133
Abbeville, AL 36310
Phone (251) 295-2815

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090918000481 AL Practitioner - Internal MedicinePractitioner - Chiropractic 1759437510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1908 Fairview Ave
Dothan, AL 36301-3008
Phone (334) 699-6863

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Dothan, AL, CCN 017159
  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue454
Removal of skin lesions85
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29664ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wiregrass Wound Care Consultants LLC Internal Medicine CurrentSince Nov 2, 2013 Accepting new patients
Houston County Healthcare Authority Internal Medicine CurrentSince Sep 1, 2009 Accepting new patients
Houston County Healthcare Authority Internal Medicine Current Accepting new patients
Houston County Healthcare Authority Internal Medicine CurrentSince Sep 1, 2009 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1118 Ross Clark Cir
Ste 303
Dothan, AL 36301
Phone (334) 794-3192

1908 Fairview Ave
Dothan, AL 36301
Phone (334) 699-6863

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": "1381449600000",
    "number": "1467529495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 CO RD 133",
            "city": "ABBEVILLE",
            "state": "AL",
            "postal_code": "36310",
            "telephone_number": "251-295-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 CO RD 133",
            "city": "ABBEVILLE",
            "state": "AL",
            "postal_code": "36310",
            "telephone_number": "251-295-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADIL",
        "first_name": "JEFFREY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2013-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "29664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abbeville, AL

Sources for this page

Verify at the official NPI Registry.