Active NPI
Ralph B Fillmore, MD
- Anesthesiology Physician
- Dothan, AL
National Provider Identifier
1487633368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 00014897
- Practice address
- 1108 Ross Clark Circle
Dothan, AL 36301 - Phone
- (334) 793-5105
- NPI assigned
- Jan 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 00014897 | AL | Primary |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 00014897 | AL |
Addresses
Primary practice location
1108 Ross Clark Circle
Dothan, AL 36301
Mailing address
1118 Ross Clark Circle
Ste 700 Anesthesia Consultants Medical Group PC
Dothan, AL 36301
Phone (334) 793-5105
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00416336A | Medicaid | GA | |
| 51081478 | Other | AL | BCBS OF ALABAMA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00014897 | AL | MD | Pain Medicine (Anesthesiology) Physician |
Interoperability endpoints
- rfillmore@direct.uabmedicine.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187740800000",
"number": "1487633368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1118 ROSS CLARK CIRCLE",
"address_2": "STE 700 ANESTHESIA CONSULTANTS MEDICAL GROUP PC",
"city": "DOTHAN",
"state": "AL",
"postal_code": "36301",
"telephone_number": "334-793-5105",
"fax_number": "334-671-5073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 ROSS CLARK CIRCLE",
"city": "DOTHAN",
"state": "AL",
"postal_code": "36301",
"telephone_number": "334-793-5105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FILLMORE",
"first_name": "RALPH",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-10",
"last_updated": "2007-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AL",
"license": "00014897",
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "AL",
"license": "00014897",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00416336A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ALABAMA",
"identifier": "51081478",
"state": "AL"
}
],
"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 Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.