Active NPI
William Matthew Fallin, P.A.
- Medical Physician Assistant
- Snead, AL
National Provider Identifier
1649477407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA-527
- Practice address
- 180 Medical Street
Snead, AL 35952 - Phone
- (205) 466-7114
- Fax
- (205) 466-3350
- NPI assigned
- Jun 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA-527 | AL | Primary |
Addresses
Primary practice location
180 Medical Street
Snead, AL 35952
Mailing address
180 Medical St
Snead, AL 35952-6468
Phone (205) 466-7114
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009910399 | Medicaid | AL | |
| 541003888 | Medicaid | AL | |
| F020 | Other | AL | SNEAD MEDICARE GROUP # |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070825000084 | AL | Practitioner - Physician Assistant | 3577655232 | Reassigns benefits to 4 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Agape Medicine LLC
Practice addresses (Care Compare)
42598 State Hwy 75
Snead, AL 35952-6566
Phone (205) 466-9096
Hospital & facility affiliations
- Prohealth Home Health, LLC
- St Vincents Blount
- Marshall Medical Centers
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-527 | AL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Vincent'S Blount | Current | Accepting new patients | |
| Signify Health, LLC | Current | Accepting new patients | |
| ENT Associates of Alabama, P.C. | Past | Accepting new patients | |
| Agape Medicine LLC | Past | Accepting new patients | |
| BHC-Blount & Etowah Counties | Past | Accepting new patients | |
| Boaz Family Medicine, PC | Past | Accepting new patients |
Locations
4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280
150 Gilbreath Dr
Oneonta, AL 35121
Phone (205) 274-3000
150 Gilbreath Dr
#201
Oneonta, AL 35121
Phone (205) 274-8198
180 Medical St
Snead, AL 35952
Phone (205) 386-4341
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Organizations & group practices 9
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.
-
- Pharmacy
- Oneonta, AL
- NPI 1730704024
-
- Family Medicine Physician
- Altoona, AL
- NPI 1073481123
-
- Family Medicine Physician
- Oneonta, AL
- NPI 1720042963
-
- Clinic/Center
- Boaz, AL
- NPI 1790840775
-
- Otolaryngology Physician
- Birmingham, AL
- NPI 1841301082
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Birmingham, AL
- NPI 1194324624
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411344000000",
"number": "1649477407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 MEDICAL ST",
"city": "SNEAD",
"state": "AL",
"postal_code": "359526468",
"telephone_number": "205-466-7114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 MEDICAL STREET",
"city": "SNEAD",
"state": "AL",
"postal_code": "35952",
"telephone_number": "205-466-7114",
"fax_number": "205-466-3350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALLIN",
"first_name": "WILLIAM",
"middle_name": "MATTHEW",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-27",
"last_updated": "2014-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AL",
"license": "PA-527",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009910399",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "541003888",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SNEAD MEDICARE GROUP #",
"identifier": "F020",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Snead, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.