Organization Active NPI

ENT Consultants

  • Otolaryngic Allergy Physician
  • Selma, AL
National Provider Identifier
1538220736
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
DO-644 Issued in AL
Legal business name
ENT CONSULTANTS
Practice address
731 Dallas Ave
Selma, AL 36701-5452
Phone
(334) 872-4778
Fax
(334) 872-8646
NPI assigned
Dec 12, 2006
Last updated
Sep 8, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
ENT CONSULTANTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Authorized official

Name
Dr. Osasere Lambert Aghedo, D.ONPI 1588725881
Title
President
Phone
(334) 872-4778

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
Otolaryngic Allergy Physician 207YX0602X DO-644 AL Primary

Addresses

Primary practice location

731 Dallas Ave
Selma, AL 36701-5452

Mailing address

731 Dallas Ave
Selma, AL 36701-5452
Phone (334) 872-4778

Other identifiers 3

IdentifierTypeStateIssuer
51039993OtherALBCBS
040014607OtherALPALMETTO RR MEDICARE
009918380MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110329000308 AL Part B Supplier - Clinic/Group Practice 2668655614 Receives reassigned benefits from 4 practitioners
Practice locations: Selma, AL

National Provider Directory

National Provider Directory
Part of
ENT Consultants

Locations

731 Dallas Ave
Selma, AL 36701
Phone (334) 872-4778

Practitioners & affiliated clinicians

Practitioners 5

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1538220736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 DALLAS AVE",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367015452",
            "telephone_number": "334-872-4778",
            "fax_number": "334-872-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 DALLAS AVE",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367015452",
            "telephone_number": "334-872-4778",
            "fax_number": "334-872-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT CONSULTANTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ENT CONSULTANTS",
        "enumeration_date": "2006-12-12",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "AGHEDO",
        "authorized_official_first_name": "OSASERE",
        "authorized_official_middle_name": "LAMBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-872-4778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "AL",
            "license": "DO-644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51039993",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "040014607",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009918380",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.