Individual provider Active NPI

Laura E Dyer, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Huntsville, AL
National Provider Identifier
1710935440
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
22942 Issued in AL
Practice address
3007 Memorial Pkwy SW
Huntsville, AL 35801-5393
Phone
(256) 799-2500
Fax
(256) 799-2519
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00022942 AL
Family Medicine Physician 207Q00000X 057362 GA
Geriatric Medicine (Family Medicine) Physician 207QG0300X 22942 AL Primary

Addresses

Primary practice location

3007 Memorial Pkwy SW
Huntsville, AL 35801-5393

Mailing address

4845 Cove Creek Dr SE
Brownsboro, AL 35741-9322
Phone (256) 536-5635

Other identifiers 4

IdentifierTypeStateIssuer
051532984OtherALBCBS
051532984MedicaidAL
7914397OtherALAETNA
051532984OtherALBCBS PROVIDER NUMBER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050323000416 AL Practitioner - Family PracticePractitioner - Geriatric MedicinePractitioner - Emergency Medicine 8527014521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00022942ALMDEmergency Medicine Physician
057362GAMDFamily Medicine Physician
22942ALMDGeriatric Medicine (Family Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1710935440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 COVE CREEK DR SE",
            "city": "BROWNSBORO",
            "state": "AL",
            "postal_code": "357419322",
            "telephone_number": "256-536-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 MEMORIAL PKWY SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015393",
            "telephone_number": "256-799-2500",
            "fax_number": "256-799-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "LAURA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00022942",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "057362",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "22942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051532984",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051532984",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7914397",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "051532984",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.