Frederick Kent Nunnally, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

00016477 Issued in AL

Practice address

4550 W Main St
Dothan, AL 36305-1130

Phone

(334) 793-6673

Fax

(877) 413-4055

NPI assigned

Apr 3, 2006

Last updated

Mar 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

University of Arkansas College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT South, PCGroup PAC ID 8123241197, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flowers Hospital Hospital, Dothan, AL, CCN 010055
• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

Merit-based Incentive Payment System (MIPS)

Final score

85.44 of 100Reported as individual

Quality

76.26

Promoting interoperability

95

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nunnally.entsouth@esp-al.direct.office.nextgen.com

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.

• ENT South, PC

  • Otolaryngology Physician
  • Dothan, AL
  • NPI 1326464066
  Medicare reassignment Care Compare group
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center Medical Clinics

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349
  NPD
• ENT Care PC

  • Specialist
  • Dothan, AL
  • NPI 1134181456
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare affiliation
• Triad of Alabama LLC

  dba Flowers Hospital

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1801830500
  Care Compare affiliation

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1689636086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051130",
            "telephone_number": "334-793-6673",
            "fax_number": "877-413-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051130",
            "telephone_number": "334-793-6673",
            "fax_number": "877-413-4055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Haven Dr",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363012907",
            "country_code": "US",
            "telephone_number": "334-793-6673",
            "fax_number": "334-792-0515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUNNALLY",
        "first_name": "FREDERICK",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "00016477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "040010260",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000031972",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "174014500",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Dothan, AL
• Providers in Dothan, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.

Verify at the official NPI Registry.