NPIMap

Organization Active NPI

West Alabama Physician Associates, LLC

Doing business as SouthEastern Spine

  • Orthopaedic Surgery of the Spine Physician
  • Tuscaloosa, AL
National Provider Identifier
1861377970
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
WEST ALABAMA PHYSICIAN ASSOCIATES, LLC
Doing business as
SouthEastern Spine
Practice address
1781 Commons North Loop
Tuscaloosa, AL 35406-3577
Phone
(205) 750-0447
NPI assigned
Aug 7, 2025
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Daniel Clay Conville
Title
Vice President, Physician Services
Phone
(205) 759-6165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

1781 Commons North Loop
Tuscaloosa, AL 35406-3577

Mailing address

1781 Commons North Loop
Tuscaloosa, AL 35406-3577

Other names 1

  • SouthEastern Spine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080918000595 AL Part B Supplier - Clinic/Group Practice 3476620311 Receives reassigned benefits from 43 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fayette, AL; Tuscaloosa, AL

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
DCH Workforce Health Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

701 University Blvd E
Ste 604
Tuscaloosa, AL 35401
Phone (205) 759-6925

701 University Blvd E
Ste 908
Tuscaloosa, AL 35401
Phone (205) 344-9393

Practitioners & affiliated clinicians

Practitioners 52

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 52

NPI Registry JSON

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

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1861377970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1781 COMMONS NORTH LOOP",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 COMMONS NORTH LOOP",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063577",
            "telephone_number": "205-750-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST ALABAMA PHYSICIAN ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "CONVILLE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "VICE PRESIDENT, PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "205-759-6165"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SouthEastern Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.