Individual provider Active NPI

Nicole Marotta McGowan

  • Certified Registered Nurse Anesthetist
  • Huntsville, AL
National Provider Identifier
1720452121
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN 1-129611 Issued in AL
Practice address
721 Madison St SE
Huntsville, AL 35801-4408
Phone
(256) 533-4888
NPI assigned
Nov 23, 2015
Last updated
Jul 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP130375 TX
Certified Registered Nurse Anesthetist 367500000X RN0000192882 TN
Certified Registered Nurse Anesthetist 367500000X RN 1-129611 AL Primary

Addresses

Primary practice location

721 Madison St SE
Huntsville, AL 35801-4408

Mailing address

721 Madison St SE
Huntsville, AL 35801-4408
Phone (256) 533-4888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200611002664 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961708789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntsville Anesthesiology Consultants PCGroup PAC ID 0749171262, 18 clinicians

Practice addresses (Care Compare)

721 Madison Sest
Huntsville, AL 35801-4408
Phone (256) 880-6711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 1-129611ALMDCertified Registered Nurse Anesthetist
RN0000192882TNMDCertified Registered Nurse Anesthetist
AP130375TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsville Anesthesiology Consultants PC Nurse Anesthetist, Certified Registered CurrentSince Jun 24, 2024 Accepting new patients
Physynergy, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients
Physynergy, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2020 Accepting new patients

Locations

1 Hospital Dr SW
Huntsville, AL 35801
Phone (256) 429-4000

721 Madison St SE
Huntsville, AL 35801
Phone (256) 533-4888

460 Lanier Rd
Madison, AL 35758
Phone (205) 558-3200

Organizations & group practices 3

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": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1720452121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 MADISON ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014408",
            "telephone_number": "256-533-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 MADISON ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014408",
            "telephone_number": "256-533-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "NICOLE",
        "middle_name": "MAROTTA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP130375",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000192882",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "RN 1-129611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.