NPIMap

Organization Active NPI

Imc-Anesthesia Services, LLC

  • Anesthesiology Physician
  • Bay Minette, AL
National Provider Identifier
1750189833
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
IMC-ANESTHESIA SERVICES, LLC
Practice address
1815 Hand Ave
Bay Minette, AL 36507-4110
Phone
(251) 937-5521
NPI assigned
Mar 5, 2025
Last updated
Mar 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Kenny Breal
Title
President Nbi & System Support
Phone
(251) 435-2077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1815 Hand Ave
Bay Minette, AL 36507-4110

Mailing address

PO Box 660257
Birmingham, AL 35266-0257
Phone (205) 979-5882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250613002591 AL Part B Supplier - Clinic/Group Practice 8022529312 Receives reassigned benefits from 11 practitioners
Practice locations: Bay Minette, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1750189833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660257",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352660257",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 HAND AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074110",
            "telephone_number": "251-937-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMC-ANESTHESIA SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "BREAL",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "PRESIDENT NBI & SYSTEM SUPPORT",
        "authorized_official_telephone_number": "251-435-2077"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Minette, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.