NPIMap

Organization Active NPI

Sylacauga Health Care Authority

  • Anesthesiology Physician
  • Sylacauga, AL
National Provider Identifier
1831676485
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
H6102 Issued in AL
Legal business name
SYLACAUGA HEALTH CARE AUTHORITY
Practice address
315 W Hickory St
Sylacauga, AL 35150-2913
Phone
(256) 401-4534
Fax
(256) 401-4603
NPI assigned
Jul 26, 2018
Organization subpart
Yes
Parent organization
SYLACAUGA HEALTH CARE AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Authorized official

Name
Roland Lee Thacker
Title
Chief Financial Officer
Phone
(256) 401-4534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X H6102 AL Primary

Addresses

Primary practice location

315 W Hickory St
Sylacauga, AL 35150-2913

Mailing address

315 W Hickory St
Sylacauga, AL 35150-2913
Phone (256) 401-4534

Other identifiers 2

IdentifierTypeStateIssuer
H6102OtherALHOSPITAL LICENSE
HOS0164HMedicaidAL

Other names 1

  • CVMC Anesthesia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727001079 AL Part B Supplier - Clinic/Group Practice 5294710398 Receives reassigned benefits from 73 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rockford, AL; Sylacauga, AL; Childersburg, AL

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Sylacauga Hlthcare Auth10 organizations share this tax ID, including this one
Part of
Sylacauga Hlthcare Auth

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532563200000",
    "number": "1831676485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W HICKORY ST",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502913",
            "telephone_number": "256-401-4534",
            "fax_number": "256-401-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W HICKORY ST",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502913",
            "telephone_number": "256-401-4534",
            "fax_number": "256-401-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYLACAUGA HEALTH CARE AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SYLACAUGA HEALTH CARE AUTHORITY",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A",
        "authorized_official_last_name": "THACKER",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "256-401-4534"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "H6102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL LICENSE",
            "identifier": "H6102",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0164H",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVMC Anesthesia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sylacauga, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.