Etowah Ear Nose & Throat, LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD27282 Issued in AL

Legal business name

ETOWAH EAR NOSE & THROAT, LLC

Practice address

1026 Goodyear Ave - Ste. 100B
Gadsden, AL 35903-1194

Phone

(256) 438-5821

Fax

(256) 467-4262

NPI assigned

Feb 3, 2014

Last updated

Feb 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert E. Osterdorf III, MD

Title

Physician

Phone

(256) 438-5821

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Alabama Medical Assoc. LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

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.

• Robert E Ostendorf III, M.D.

  • Otolaryngology Physician
  • Gadsden, AL
  • NPI 1003833021
  Medicare reassignment NPD

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1881017424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8365",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359028365",
            "telephone_number": "256-543-2867",
            "fax_number": "256-459-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 GOODYEAR AVE - STE. 100B",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031194",
            "telephone_number": "256-438-5821",
            "fax_number": "256-467-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETOWAH EAR NOSE & THROAT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-03",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "OSTERDORF",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "256-438-5821",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "MD27282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009912008",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Alabama Medical Assoc. LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Etowah County Health Dept Pat 1St CM
• Etowah County Health Dept Prev Health Ed
• Etowah County Health Dept Pri Care
• Etowah County Health Dept STD
• Etowah County Health Dept VFC Immun
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• Etowah Gastroenterology Associates PC
• Jason Faile, LPTA
• Steven Mark Fain
• Jeffrey Barnett Fairchild, D.M.D.

• Otolaryngology Physician in Gadsden, AL
• Providers in Gadsden, AL by specialty
• Otolaryngology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.