NPIMap

Organization Active NPI

Anesthesia Services of Decatur PC

  • Anesthesiology Physician
  • Decatur, AL
National Provider Identifier
1629034624
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIA SERVICES OF DECATUR PC
Practice address
1201 7TH St SE
Decatur, AL 35601-3337
Phone
(256) 341-2000
Fax
(256) 350-2609
NPI assigned
Apr 26, 2006
Last updated
Jan 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Authorized official

Name
Jennie Delashaw
Title
Business Manager
Phone
(256) 221-7482

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1201 7TH St SE
Decatur, AL 35601-3337

Mailing address

PO Box 757
Florence, AL 35631-0757
Phone (256) 764-9697

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412001701 AL Part B Supplier - Clinic/Group Practice 4183618226 Receives reassigned benefits from 39 practitioners
Practice locations: Decatur, AL

National Provider Directory

National Provider Directory

Locations

1900 Flint Rd SE
Decatur, AL 35601

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1629034624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356310757",
            "telephone_number": "256-764-9697",
            "fax_number": "256-764-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 7TH ST SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013337",
            "telephone_number": "256-341-2000",
            "fax_number": "256-350-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA SERVICES OF DECATUR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "DELASHAW",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "256-221-7482"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.