Individual provider Active NPI

William Langley Pridgen, M.D.

  • Surgery Physician
  • Tuscaloosa, AL
National Provider Identifier
1629017736
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
00022573 Issued in AL
Practice address
1837 Commons North Dr
Tuscaloosa, AL 35406-3700
Phone
(205) 366-0696
Fax
(205) 366-1451
NPI assigned
Jun 5, 2006
Last updated
Aug 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 00022573 AL Primary

Addresses

Primary practice location

1837 Commons North Dr
Tuscaloosa, AL 35406-3700

Mailing address

1837 Commons North Dr
Tuscaloosa, AL 35406-3700
Phone (205) 366-0696

Other identifiers 2

IdentifierTypeStateIssuer
51098967OtherALBLUE CROSS AND BLUE SHIELD OF ALABAMA
1629017736MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041124000375 AL Practitioner - General Surgery 3870557366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Tennessee, HSC, College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1837 Commons N Dr
Tuscaloosa, AL 35406-3700
Phone (205) 366-0696

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00022573ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuscaloosa Surgical Associates, P.C. Surgery CurrentSince Oct 6, 2000 Accepting new patients

Locations

1837 Commons North Dr
Tuscaloosa, AL 35406
Phone (205) 366-0696

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1629017736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 COMMONS NORTH DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063700",
            "telephone_number": "205-366-0696",
            "fax_number": "205-366-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1837 COMMONS NORTH DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063700",
            "telephone_number": "205-366-0696",
            "fax_number": "205-366-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDGEN",
        "first_name": "WILLIAM",
        "middle_name": "LANGLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "00022573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF ALABAMA",
            "identifier": "51098967",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629017736",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.