Edith C Agee, PHYSICIAN ASSISTANT
Individual provider Active NPI Surgical Physician Assistant · Montgomery, AL
NPI 1821295544 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821295544
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- PA-62 (AL)
- Practice address
- 2101 Chestnut St
Montgomery, AL 36106-1112 - Phone
- (334) 265-9225
- Fax
- (334) 240-6653
- NPI assigned
- Jun 27, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Alabama School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Jackson Hospital and Clinic, Inc
Practice addresses (Care Compare)
1722 Pine St
Montgomery, AL 36106-1160
Hospital & facility affiliations
- Jackson Hospital & Clinic Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120725000574 | AL | Practitioner - Physician Assistant | 0042476673 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-62 | AL | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nes Tennessee Inc | Current |
Accepting new patients | |
| Jackson Hospital & Clinic, Inc. | Current |
Accepting new patients | |
| Jackson Hospital & Clinic, Inc. | Current |
Accepting new patients | |
| Jackson Hospital & Clinic, Inc. | Past | Accepting new patients |
Locations
1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000
1722 Pine St
Ste 804
Montgomery, AL 36106
Phone (334) 834-7221
1722 Pine St
Ste 502
Montgomery, AL 36106
Phone (334) 293-8123
1722 Pine St
Ste 904
Montgomery, AL 36106
Phone (334) 265-9225
315 W Hickory St
Sylacauga, AL 35150
Phone (256) 249-5000
7300 State Highway 121
Ste 370374
McKinney, TX 75070
Interoperability endpoints
- edith.agee.1@9186.direct.athenahealth.com
- edith.agee.d1.p1@direct.extendedarm.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA-62 | AL | Yes |
Addresses
Primary practice location
2101 Chestnut St
Montgomery, AL 36106-1112
Mailing address
2101 Chestnut St
Montgomery, AL 36106-1112
Phone (334) 265-9225
Other providers in Montgomery, AL
- Uduak Afangideh
- Affirming Care Counseling and Wellness LLC
- Affordable Dentures & Implants - Montgomery, P.C.
- Tijil Agarwal
- Angelo K Agee
- Himanshu Aggarwal
- Sonya Aghili-Mehrizi
- Agilitas USA, Inc
- Muhammad Ahmad
- M. Luqman Ahmed
All providers in Montgomery, AL · Surgical Physician Assistant in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.