Southern Alabama Regional Council on Aging

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

1-054943 Issued in AL

Legal business name

SOUTHERN ALABAMA REGIONAL COUNCIL ON AGING

Practice address

1075 S Brannon Stand Rd
Dothan, AL 36305-7359

Phone

(334) 793-6843

NPI assigned

Oct 7, 2016

Last updated

Apr 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dana Eidson

Title

Executive Director

Phone

(334) 793-6843

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555545600000",
    "number": "1487104998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 S BRANNON STAND RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363057359",
            "telephone_number": "334-793-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 S BRANNON STAND RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363057359",
            "telephone_number": "334-793-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ALABAMA REGIONAL COUNCIL ON AGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2019-04-18",
        "status": "A",
        "authorized_official_last_name": "EIDSON",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "334-793-6843"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "AL",
            "license": "1-054943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diabetes Educator Registered Nurse in Dothan, AL
• Providers in Dothan, AL by specialty
• Diabetes Educator Registered Nurse in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.