NPIMap

Organization Active NPI

West Alabama Physician Associates LLC

Doing business as West Alabama Cardiac Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Tuscaloosa, AL
National Provider Identifier
1891296547
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
WEST ALABAMA PHYSICIAN ASSOCIATES LLC
Doing business as
West Alabama Cardiac Surgery
Practice address
701 University Blvd E Ste 807
Tuscaloosa, AL 35401-7479
Phone
(205) 759-6873
NPI assigned
Feb 27, 2018
Last updated
Feb 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

701 University Blvd E Ste 807
Tuscaloosa, AL 35401-7479

Mailing address

701 University Blvd E Ste 807
Tuscaloosa, AL 35401-7479
Phone (205) 759-6873

Other names 1

  • West Alabama Cardiac Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180816002345 AL Part B Supplier - Clinic/Group Practice 3476620311 Receives reassigned benefits from 10 practitioners
Practice locations: Tuscaloosa, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1891296547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 UNIVERSITY BLVD E STE 807",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017479",
            "telephone_number": "205-759-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 UNIVERSITY BLVD E STE 807",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017479",
            "telephone_number": "205-759-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST ALABAMA PHYSICIAN ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-27",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "CONVILLE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "205-759-6165"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Alabama Cardiac Surgery",
            "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 Feb 17, 2023; 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.