NPIMap

Organization Active NPI

ENT Associates of Alabama, P.C.

  • Otolaryngology Physician
  • Birmingham, AL
National Provider Identifier
1841301082
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ENT ASSOCIATES OF ALABAMA, P.C.
Practice address
833 Saint Vincents Dr
Pob#3 Suite 402
Birmingham, AL 35205-1606
Phone
(205) 933-9236
Fax
(205) 933-9213
NPI assigned
Aug 31, 2006
Last updated
Aug 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Authorized official

Name
Ms. Dianne P Nichols
Title
Chief Operating Officer
Phone
(205) 933-9236

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

833 Saint Vincents Dr
Pob#3 Suite 402
Birmingham, AL 35205-1606

Mailing address

833 Saint Vincents Dr
Pob#3 Suite 402
Birmingham, AL 35205-1606
Phone (205) 933-9236

Other identifiers 1

IdentifierTypeStateIssuer
000060077MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051025001005 AL Part B Supplier - Clinic/Group Practice 8921025354 Receives reassigned benefits from 48 practitioners
Practice locations: Birmingham, AL; Pell City, AL; Jasper, AL; Hoover, AL; Gardendale, AL; Cullman, AL; Alabaster, AL; Bessemer, AL

National Provider Directory

National Provider Directory

Locations

644 2nd St NE
Ste 107
Alabaster, AL 35007
Phone (205) 621-2020

5000 Medical West Way
Ste 406
Bessemer, AL 35022
Phone (205) 481-8620

3686 Grandview Pkwy
Ste 530
Birmingham, AL 35243
Phone (205) 591-8260

48 Medical Park Dr E
Ste 153
Birmingham, AL 35235
Phone (205) 402-8133

880 Montclair Rd
Ste 372
Birmingham, AL 35213
Phone (205) 591-8260

1948 AL Highway 157
Ste 410
Cullman, AL 35058
Phone (205) 734-9370

931 Sharit Ave
Ste 101
Gardendale, AL 35071
Phone (205) 581-8820

3400 Highway 78 E
Ste 205
Jasper, AL 35501
Phone (205) 221-4630

Practitioners & affiliated clinicians

Practitioners 65

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 65

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377216000000",
    "number": "1841301082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SAINT VINCENTS DR",
            "address_2": "POB#3 SUITE 402",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051606",
            "telephone_number": "205-933-9236",
            "fax_number": "205-933-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SAINT VINCENTS DR",
            "address_2": "POB#3 SUITE 402",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051606",
            "telephone_number": "205-933-9236",
            "fax_number": "205-933-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT ASSOCIATES OF ALABAMA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-08-23",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "205-933-9236",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000060077",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.