NPIMap

Organization Active NPI

Physynergy, LLC

  • Anesthesiology Physician
  • Huntsville, AL
National Provider Identifier
1780060079
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
999999 Issued in AL
Legal business name
PHYSYNERGY, LLC
Practice address
119 Longwood Dr SW
Huntsville, AL 35801-4522
Phone
(256) 469-7895
Fax
(256) 270-8937
NPI assigned
Aug 10, 2015
Last updated
Aug 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Authorized official

Name
Timothy Killen Adams Jr., MD
Title
President
Phone
(256) 469-7895

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X 999999 AL Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 99999 AL
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X 99999 AL
Anesthesiologist AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 367H00000X 99999 AL

Addresses

Primary practice location

119 Longwood Dr SW
Huntsville, AL 35801-4522

Mailing address

PO Box 52404
Lafayette, LA 70505-2404
Phone (706) 860-2701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130222000456 AL Part B Supplier - Clinic/Group Practice 6204081292 Receives reassigned benefits from 217 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntsville, AL; Madison, AL; Mobile, AL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Physynergy LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1780060079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52404",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052404",
            "telephone_number": "706-860-2701",
            "fax_number": "706-860-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 LONGWOOD DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014522",
            "telephone_number": "256-469-7895",
            "fax_number": "256-270-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSYNERGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "KILLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-469-7895",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "999999",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AL",
            "license": "99999",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "99999",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiologist Assistant",
            "state": "AL",
            "license": "99999",
            "primary": false
        }
    ],
    "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 Aug 10, 2015; 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.