NPIMap

Organization Active NPI

Marshall Medical Center South

Doing business as CRNA Professional Services

  • Certified Registered Nurse Anesthetist
  • Boaz, AL
National Provider Identifier
1497269799
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MARSHALL MEDICAL CENTER SOUTH
Doing business as
CRNA Professional Services
Practice address
2505 US Highway 431
Boaz, AL 35957-5908
Phone
(256) 593-8310
Fax
(256) 840-3647
NPI assigned
Nov 22, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mrs. Kathy Nelson
Title
Cfo
Phone
(256) 894-6701

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

2505 US Highway 431
Boaz, AL 35957-5908

Mailing address

227 Brittany Rd
Guntersville, AL 35976-5766
Phone (256) 894-6600

Other practice location 1

8000 Al Highway 69
Guntersville, AL 35976-7140
Phone (256) 571-8000

Other names 1

  • CRNA Professional Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180503001351 AL Part B Supplier - Clinic/Group Practice 0648534495 Receives reassigned benefits from 56 practitioners
Practice locations: Guntersville, AL; Boaz, AL

National Provider Directory

National Provider Directory

Locations

2505 US Highway 431
Ste 104
Boaz, AL 35957

Practitioners & affiliated clinicians

Practitioners 56

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.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1497269799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 BRITTANY RD",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359765766",
            "telephone_number": "256-894-6600",
            "fax_number": "256-894-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 US HIGHWAY 431",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575908",
            "telephone_number": "256-593-8310",
            "fax_number": "256-840-3647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8000 Al Highway 69",
            "address_purpose": "LOCATION",
            "city": "Guntersville",
            "state": "AL",
            "postal_code": "359767140",
            "country_code": "US",
            "telephone_number": "256-571-8000",
            "fax_number": "256-571-8004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARSHALL MEDICAL CENTER SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-22",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "256-894-6701",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRNA Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boaz, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.