Individual provider Active NPI

Myrtell Lorraine Cantrell, PA-C

  • Physician Assistant
  • Rainbow City, AL
National Provider Identifier
1689610727
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-66 Issued in AL
Practice address
99 Boyd Place
Rainbow City, AL 35906
Phone
(256) 442-5666
NPI assigned
Jun 20, 2006
Last updated
Mar 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-66 AL Primary

Addresses

Primary practice location

99 Boyd Place
Rainbow City, AL 35906

Mailing address

99 Boyd Place
Rainbow City, AL 35906
Phone (256) 442-5666

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
I20060228000358 AL Practitioner - Physician Assistant 5991711947 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern NP Associates LLCGroup PAC ID 1557686243, 52 clinicians

Practice addresses (Care Compare)

410 Wilson SWDR
Jacksonville, AL 36265-2754
Phone (205) 343-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-66ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Emergency Physicians LLC CurrentSince Mar 1, 2012 Accepting new patients
Alabama Emergency Physician Partners, LLC CurrentSince Feb 1, 2013 Accepting new patients
Southern NP Associates, LLC CurrentSince Jun 4, 2018 Accepting new patients
Nes Tennessee Inc CurrentSince Apr 7, 2018 Accepting new patients
Riverview Emergency Physicians LLC Past Accepting new patients
Carraway Emergency Physicians, LLC Past Accepting new patients
St. Clair Emergency Physicians, LLC. Past Accepting new patients

Locations

800 Montclair Rd
Birmingham, AL 35213
Phone (205) 592-1000

22969 Highway 25
Columbiana, AL 35051
Phone (205) 669-1712

600 S 3rd St
Gadsden, AL 35901
Phone (256) 543-5200

410 Wilson Dr SW
Jacksonville, AL 36265
Phone (256) 435-7704

931 Fairfax Park
Tuscaloosa, AL 35406
Phone (205) 343-7301

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1689610727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 BOYD PLACE",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "35906",
            "telephone_number": "256-442-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BOYD PLACE",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "35906",
            "telephone_number": "256-442-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "MYRTELL",
        "middle_name": "LORRAINE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA-66",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rainbow City, AL

Sources for this page

Verify at the official NPI Registry.