Individual provider Active NPI

Becky R Parker, CRNA

  • Certified Registered Nurse Anesthetist
  • Dothan, AL
National Provider Identifier
1477792547
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-072809 Issued in AL
Practice address
301 Medical Park Boulevard
Dothan, AL 36301-3630
Phone
(334) 305-2699
NPI assigned
Feb 13, 2009
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-072809 AL Primary

Addresses

Primary practice location

301 Medical Park Boulevard
Dothan, AL 36301-3630

Mailing address

480 Honeysuckle Rd
Dothan, AL 36305-1156
Phone (334) 836-1052

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090514000436 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981753332 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gut PCGroup PAC ID 3375589799, 53 clinicians

Practice addresses (Care Compare)

1450 Ross Clark Cir
Suite 4
Dothan, AL 36301-4736
Phone (334) 836-1212

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-072809ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan Anesthesiology Associates PC CurrentSince May 1, 2013 Accepting new patients
Gut PC CurrentSince Oct 9, 2022 Accepting new patients
Southern Alabama Surgery Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2016 Accepting new patients
Gut Endo, LLC CurrentSince Oct 9, 2022 Accepting new patients
Gut PC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients

Locations

1450 Ross Clark Cir
Ste 4
Dothan, AL 36301
Phone (334) 699-7900

2800 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-3411

2800 Ross Clark Cir
Ste 3
Dothan, AL 36301
Phone (334) 793-3411

301 Medical Park Blvd
Dothan, AL 36301
Phone (334) 305-2699

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

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

400 N Edwards St
Enterprise, AL 36330
Phone (334) 347-0584

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, 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": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1477792547",
    "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": "363051156",
            "telephone_number": "334-836-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEDICAL PARK BOULEVARD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013630",
            "telephone_number": "334-305-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BECKY",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2022-10-03",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-072809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.