NPIMap

Organization Active NPI

Avalon Surgical,P.C.

  • Surgery Physician
  • Sheffield, AL
National Provider Identifier
1790955920
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5762 Issued in AL
Legal business name
AVALON SURGICAL,P.C.
Practice address
1120 S Jackson Hwy Ste 307
Sheffield, AL 35660-5773
Phone
(256) 381-0030
Fax
(256) 383-0764
NPI assigned
Mar 4, 2008
Last updated
Jul 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Authorized official

Name
Dr. David Parks McKinley, M.D.,NPI 1043335151
Title
President
Phone
(256) 381-0030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5762 AL Primary

Addresses

Primary practice location

1120 S Jackson Hwy Ste 307
Sheffield, AL 35660-5773

Mailing address

PO Box 298
Sheffield, AL 35660-0298
Phone (256) 381-0030

Other identifiers 5

IdentifierTypeStateIssuer
00780OtherALFIRSTCOMMUNITY
10912029OtherALCAQH
17-00656OtherALUNITEDHEALTHCARE
529926920MedicaidAL
DD6002OtherALMETRAHEALTH/RAILROAD

National Provider Directory

National Provider Directory

Locations

1100 S Jackson Hwy
Sheffield, AL 35660
Phone (256) 381-0030

1100 S Jackson Hwy
Ste 104
Sheffield, AL 35660
Phone (256) 381-0030

1120 S Jackson Hwy
Ste 307
Sheffield, AL 35660
Phone (256) 381-0030

Practitioners & affiliated clinicians

Practitioners 2

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": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1790955920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 298",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356600298",
            "telephone_number": "256-381-0030",
            "fax_number": "256-383-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S JACKSON HWY STE 307",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356605773",
            "telephone_number": "256-381-0030",
            "fax_number": "256-383-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON SURGICAL,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "MCKINLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "PARKS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-381-0030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "5762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCOMMUNITY",
            "identifier": "00780",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10912029",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "17-00656",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529926920",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METRAHEALTH/RAILROAD",
            "identifier": "DD6002",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheffield, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.