Andalusia Greater Regional Otolaryngology ENT P C

Primary specialty

SpecialistTaxonomy code 174400000X

License

12982 Issued in AL

Legal business name

ANDALUSIA GREATER REGIONAL OTOLARYNGOLOGY ENT P C

Practice address

300 Medical Avenue
2
Andalusia, AL 36420-1201

Phone

(334) 427-2476

Fax

(334) 427-2477

NPI assigned

Feb 20, 2008

Last updated

Dec 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rickey G Love, M.D.

Title

Doctor/President

Phone

(334) 427-2476

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AGRO ENT Other name

Locations

Practitioners 1

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.

• Angelene Naro

  • Audiologist
  • Brewton, AL
  • NPI 1780846576
  NPD (past)

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1548438815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL AVENUE",
            "address_2": "2",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364201201",
            "telephone_number": "334-427-2476",
            "fax_number": "334-427-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL AVENUE",
            "address_2": "2",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364201201",
            "telephone_number": "334-427-2476",
            "fax_number": "334-427-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDALUSIA GREATER REGIONAL OTOLARYNGOLOGY ENT P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "RICKEY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DOCTOR/PRESIDENT",
        "authorized_official_telephone_number": "334-427-2476",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "12982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529914990",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AGRO ENT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Specialist in Andalusia, AL
• Providers in Andalusia, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.