Active NPI
Ellen Virginia Dragsten, MD
- Pediatrics Physician
- Decatur, AL
National Provider Identifier
1891726527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 00020153
- Practice address
- 68 Marco Drive SE
Decatur, AL 35603-0000 - Phone
- (256) 432-2007
- Fax
- (256) 432-2010
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 00020153 | AL | Primary |
Addresses
Primary practice location
68 Marco Drive SE
Decatur, AL 35603-0000
Mailing address
PO Box 970
Russellville, AL 35653-0970
Phone (256) 332-1631
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 630102047 | Medicaid | AL | |
| 51525668 | Other | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00020153 | AL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1891726527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 970",
"city": "RUSSELLVILLE",
"state": "AL",
"postal_code": "356530970",
"telephone_number": "256-332-1631",
"fax_number": "256-332-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 MARCO DRIVE SE",
"city": "DECATUR",
"state": "AL",
"postal_code": "356030000",
"telephone_number": "256-432-2007",
"fax_number": "256-432-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAGSTEN",
"first_name": "ELLEN",
"middle_name": "VIRGINIA",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "00020153",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630102047",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "51525668",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.