ENT Bessemer, LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

12109 Issued in AL

Legal business name

ENT BESSEMER, LLC

Practice address

985 9TH Ave SW
Suite 308
Bessemer, AL 35022-4500

Phone

(205) 481-7780

Fax

(205) 481-7740

NPI assigned

May 23, 2008

Organization subpart

No

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

Authorized official

Name

Gretchen K Gilliland

Title

Billing

Phone

(205) 481-7780

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anne K Penhale, M.S., CCC-A

  • Audiologist
  • Bessemer, AL
  • NPI 1407061906
  NPD (past)

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313366400000",
    "number": "1639337934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 9TH AVE SW",
            "address_2": "SUITE 308",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350224500",
            "telephone_number": "205-481-7780",
            "fax_number": "205-481-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 9TH AVE SW",
            "address_2": "SUITE 308",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350224500",
            "telephone_number": "205-481-7780",
            "fax_number": "205-481-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT BESSEMER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2011-08-15",
        "status": "A",
        "authorized_official_last_name": "GILLILAND",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "205-481-7780"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "12109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1010135",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ALABAMA",
            "identifier": "51045124",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "420842449",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529900180",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally McNeill Ebaugh, M.D.
• Adesola Ebolum, PHARM D.
• Amechi Echetebu, DDS
• Elrod Sales and Service Inc
• Encore Rehabilitation, Inc.
• Jonathan C Estes
• John Kevin Ewing, CRNA
• Jennifer Fairchild
• Family Associated Charity of Alabama
• Family Comfort Hospice, LLC (Family Comfort Hospice of Bessemer)

• Otolaryngology Physician in Bessemer, AL
• Providers in Bessemer, AL by specialty
• Otolaryngology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.