Organization Active NPI

David Anakwenze MD Psychiatric Outreach LLC

  • Psychiatry Physician
  • Florence, AL
National Provider Identifier
1487722302
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
AL23908 Issued in AL
Legal business name
DAVID ANAKWENZE MD PSYCHIATRIC OUTREACH LLC
Practice address
2809 W Mall Dr
Florence, AL 35630-1563
Phone
(256) 767-4805
Fax
(256) 767-4954
NPI assigned
Nov 30, 2006
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
David Anakwenze, MDNPI 1356306559
Title
Medical Doctor
Phone
(256) 767-4805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X AL23908 AL Primary

Addresses

Primary practice location

2809 W Mall Dr
Florence, AL 35630-1563

Mailing address

2809 W Mall Dr
Florence, AL 35630-1563
Phone (256) 767-4805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070205000383 AL Part B Supplier - Clinic/Group Practice 8921000951 Receives reassigned benefits from 2 practitioners
Practice locations: Florence, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1072795Psychiatric Outreach LLC2809 West Mall Dr, Florence, AL 35630Certificate of waiverAug 22, 2027

National Provider Directory

National Provider Directory

Locations

115B Helton Ct
Florence, AL 35630
Phone (256) 767-4805

2809 W Mall Dr
Florence, AL 35630
Phone (256) 767-4805

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1487722302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 W MALL DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301563",
            "telephone_number": "256-767-4805",
            "fax_number": "256-767-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 W MALL DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301563",
            "telephone_number": "256-767-4805",
            "fax_number": "256-767-4954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID ANAKWENZE MD PSYCHIATRIC OUTREACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "ANAKWENZE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "256-767-4805",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "AL23908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.