Athens Limestone Surgical Clinic
Organization Active NPI Surgery Physician · Athens, AL
NPI 1689201766 · NPPES record last updated Jan 5, 2024
Key facts
- NPI
- 1689201766
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- ATHENS LIMESTONE SURGICAL CLINIC
- Practice address
- 101 Fitness Way Ste 2100
Athens, AL 35611-2494 - Phone
- (256) 262-6190
- Fax
- (256) 262-6199
- NPI assigned
- Mar 26, 2020
- Organization subpart
- No
Authorized official
- Name
- Sebrina B Holt
- Title
- Director of Physician Network
- Phone
- (256) 216-9648
Practitioners 3
-
Carolyn Maude Johnson, CRNP
-
Steven W. Kinsey, M.D.
-
Danisa M. Clarrett, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200515002442 | AL | Part B Supplier - Clinic/Group Practice | 4284065731 |
Receives reassigned benefits from 3 practitioners Practice locations: Athens, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
101 Fitness Way Ste 2100
Athens, AL 35611-2494
Mailing address
101 Fitness Way Ste 2100
Athens, AL 35611-2494
Phone (256) 262-6190
Other providers in Athens, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.