Active NPI
Carl W Hartzog, MD
- Orthopaedic Surgery Physician
- Gadsden, AL
National Provider Identifier
1891730818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 6015
- Practice address
- 100 Medical Center Dr.
Suite 101
Gadsden, AL 35903-1130 - Phone
- (256) 492-8590
- Fax
- (256) 492-4498
- NPI assigned
- Jun 17, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 6015 | AL | Primary |
Addresses
Primary practice location
100 Medical Center Dr.
Suite 101
Gadsden, AL 35903-1130
Mailing address
100 Medical Center Dr.
Suite 101
Gadsden, AL 35903-1130
Phone (256) 492-8590
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000002477 | Medicaid | AL | |
| 2477 | Medicaid | AL | |
| 51002477 | Other | AL | BCBS AL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | c.william.hartzog.1@1831.direct.athenahealth.com | Direct |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6015 | AL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1891730818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MEDICAL CENTER DR.",
"address_2": "SUITE 101",
"city": "GADSDEN",
"state": "AL",
"postal_code": "359031130",
"telephone_number": "256-492-8590",
"fax_number": "256-492-8590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MEDICAL CENTER DR.",
"address_2": "SUITE 101",
"city": "GADSDEN",
"state": "AL",
"postal_code": "359031130",
"telephone_number": "256-492-8590",
"fax_number": "256-492-4498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTZOG",
"first_name": "CARL",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-17",
"last_updated": "2020-10-01",
"certification_date": "2020-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AL",
"license": "6015",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000002477",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2477",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS AL",
"identifier": "51002477",
"state": "AL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "c.william.hartzog.1@1831.direct.athenahealth.com",
"affiliation": "N",
"endpointDescription": "AMR Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "100 Medical Center Dr.",
"address_2": "Suite 101",
"city": "Gadsden",
"state": "AL",
"country_code": "US",
"postal_code": "359031130",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gadsden, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.