Individual provider Active NPI

Andrew Powelson, MD

  • Anesthesiology Physician
  • Charleston, SC
National Provider Identifier
1477816130
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
LL34909 Issued in SC
Practice address
167 Ashley Ave
Suite 301
Charleston, SC 29425-9120
Phone
(843) 792-2437
NPI assigned
Jun 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X LL34909 SC Primary

Addresses

Primary practice location

167 Ashley Ave
Suite 301
Charleston, SC 29425-9120

Mailing address

167 Ashley Ave
Suite 301
Charleston, SC 29425-9120

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
I20160823002317 AL Practitioner - Anesthesiology 3779872692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northeastern Ohio University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Lake Health Springhill LLCGroup PAC ID 2365830007, 47 clinicians
Anesthesiologists Associated PCGroup PAC ID 6204739519, 418 clinicians

Practice addresses (Care Compare)

3719 Dauphin St
Mobile, AL 36608-1753
Phone (251) 460-5220

701 Princeton Ave SW
Birmingham, AL 35211-1303
Phone (205) 848-2925

Hospital & facility affiliations

  • Mobile Infirmary Medical Center Hospital, Mobile, AL, CCN 010113
  • Springhill Medical Center Hospital, Mobile, AL, CCN 010144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL34909SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Lake Health Springhill, LLC Anesthesiology CurrentSince Nov 1, 2021 Accepting new patients
Anesthesiologists Associated PC Anesthesiology CurrentSince May 1, 2018 Accepting new patients
Anesthesiologists Associated PC CurrentSince May 1, 2018 Accepting new patients
Medical University of South Carolina Past Accepting new patients

Locations

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

3719 Dauphin St
Mobile, AL 36608
Phone (251) 342-3000

4600 N Davis Hwy
Pensacola, FL 32503
Phone (850) 202-1118

Organizations & group practices 4

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": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1477816130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 ASHLEY AVE",
            "address_2": "SUITE 301",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294259120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 ASHLEY AVE",
            "address_2": "SUITE 301",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294259120",
            "telephone_number": "843-792-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELSON",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "LL34909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.