Individual provider Active NPI

Alexander Eganhouse

  • Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1639560964
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-125771 Issued in AL
Practice address
4700 Whitesburg Dr SW Ste 200
Huntsville, AL 35802-1686
Phone
(256) 882-1450
Fax
(256) 882-3823
NPI assigned
Feb 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-125771 AL Primary

Addresses

Primary practice location

4700 Whitesburg Dr SW Ste 200
Huntsville, AL 35802-1686

Mailing address

4700 Whitesburg Dr SW Ste 200
Huntsville, AL 35802-1686
Phone (256) 882-1450

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240311001353 AL Practitioner - Nurse Practitioner 6608170618 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Cardiology, P.C. CurrentSince Jan 30, 2024 Accepting new patients

Locations

4700 Whitesburg Dr SW
Ste 200
Huntsville, AL 35802
Phone (256) 882-1450

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCCFCA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1639560964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WHITESBURG DR SW STE 200",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021686",
            "telephone_number": "256-882-1450",
            "fax_number": "256-882-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WHITESBURG DR SW STE 200",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021686",
            "telephone_number": "256-882-1450",
            "fax_number": "256-882-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGANHOUSE",
        "first_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-125771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.