Individual provider Active NPI

Amelia J Whiddon, CRNA

  • Certified Registered Nurse Anesthetist
  • Greenville, AL
National Provider Identifier
1528043684
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1044400 Issued in AL
Practice address
29 L V Stabler Dr
Greenville, AL 36037-3850
Phone
(334) 383-2210
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1044400 AL Primary

Addresses

Primary practice location

29 L V Stabler Dr
Greenville, AL 36037-3850

Mailing address

PO Box 1547
Sedalia, MO 65302-1547
Phone (660) 826-5960

Other identifiers 3

IdentifierTypeStateIssuer
510-78519OtherALBCBS
009978255MedicaidAL
P00156296OtherALRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001080 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618867292 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Montgomery PC 117 clinicians

Practice addresses (Care Compare)

470 Taylor Rd
Suite 100
Montgomery, AL 36117-3532
Phone (334) 290-4530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1044400ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered CurrentSince Feb 4, 2024 Accepting new patients
Rmcca Clinic a LLC CurrentSince Oct 17, 2018 Accepting new patients

Locations

849 S Three Notch St
Andalusia, AL 36420
Phone (334) 222-6953

29 L V Stabler Dr
Greenville, AL 36037
Phone (334) 382-2676

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

470 Taylor Rd
Ste 100
Montgomery, AL 36117
Phone (334) 284-9600

702 N Main St
Opp, AL 36467
Phone (334) 493-2342

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.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1528043684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547",
            "telephone_number": "660-826-5960",
            "fax_number": "660-826-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 L V STABLER DR",
            "city": "GREENVILLE",
            "state": "AL",
            "postal_code": "360373850",
            "telephone_number": "334-383-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHIDDON",
        "first_name": "AMELIA",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1044400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510-78519",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009978255",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00156296",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; 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.