Etowah Gastroenterology Associates PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD23716 Issued in AL

Legal business name

ETOWAH GASTROENTEROLOGY ASSOCIATES PC

Practice address

1026 Goodyear Ave
Suite 201
Gadsden, AL 35903-1194

Phone

(256) 467-4477

Fax

(256) 467-4830

NPI assigned

Nov 23, 2007

Last updated

Jan 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vipul T Amin, MDNPI 1720070659

Title

Provider

Phone

(256) 467-4477

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IEDBCA

Practitioners 4

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.

• Vipul Thakorbhai Amin, MD

  • Gastroenterology Physician
  • Gadsden, AL
  • NPI 1720070659
  Medicare reassignment Care Compare group Authorized official
• Amber Walker, CRNP

  • Acute Care Nurse Practitioner
  • Boaz, AL
  • NPI 1811448202
  Medicare reassignment Care Compare group NPD
• Angela Walker, CRNP

  • Adult Health Nurse Practitioner
  • Gadsden, AL
  • NPI 1568703957
  Medicare reassignment NPD
• Pankaj Kumar Kashyap, M.D.

  • Specialist
  • Anniston, AL
  • NPI 1609864248
  NPD (past)

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1750562492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 GOODYEAR AVE",
            "address_2": "SUITE 201",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031194",
            "telephone_number": "256-467-4477",
            "fax_number": "256-467-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 GOODYEAR AVE",
            "address_2": "SUITE 201",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031194",
            "telephone_number": "256-467-4477",
            "fax_number": "256-467-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETOWAH GASTROENTEROLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "AMIN",
        "authorized_official_first_name": "VIPUL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "256-467-4477",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "MD23716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51523153",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009969840",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Etowah County Health Dept Pri Care
• Etowah County Health Dept STD
• Etowah County Health Dept VFC Immun
• Etowah Ear Nose & Throat, LLC
• Etowah Foot Specialists, Inc.
• Jason Faile, LPTA
• Steven Mark Fain
• Jeffrey Barnett Fairchild, D.M.D.
• Kristi Kell Falco, CRNA
• Family Success Center of Etowah County, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.