Active NPI
Alan Douglas Northcutt, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Waco, TX
National Provider Identifier
1689685125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- G3654
- Practice address
- 100 Hillcrest Medical Blvd
Pathology Dept
Waco, TX 76712-8897 - Phone
- (254) 202-4816
- Fax
- (254) 202-4899
- NPI assigned
- Aug 10, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology (Pathology) Physician | 207ZD0900X | G3654 | TX | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | G3654 | TX | Primary |
Addresses
Primary practice location
100 Hillcrest Medical Blvd
Pathology Dept
Waco, TX 76712-8897
Mailing address
PO Box 21509
Waco, TX 76702-1509
Phone (614) 442-2406
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129416705 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1689685125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21509",
"city": "WACO",
"state": "TX",
"postal_code": "767021509",
"telephone_number": "614-442-2406",
"fax_number": "614-442-2410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HILLCREST MEDICAL BLVD",
"address_2": "PATHOLOGY DEPT",
"city": "WACO",
"state": "TX",
"postal_code": "767128897",
"telephone_number": "254-202-4816",
"fax_number": "254-202-4899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTHCUTT",
"first_name": "ALAN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207ZD0900X",
"taxonomy_group": "",
"desc": "Pathology, Dermatopathology",
"state": "TX",
"license": "G3654",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "TX",
"license": "G3654",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129416705",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
- Renissa Norman
- Tamala Norris, DHA, RN, BSN
- Karen Elaine Nors-Cox, COTA
- North Mesa Dental, PC (Topaz Dentistry)
- North Mesa Dental, PC (Resolution Dental)
- Jeremiah Rosendo Northern, PHARM D
- Kristen Lee Northern, RN, FNP-BC
- Vicki Carol Northern, LMSW
- Northland Hearing Centers Inc (Sears Hearing Aid Centers)
- Evan Norton, PSY.D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.