Individual provider Active NPI

Dylan Addis

  • Anesthesiology Physician
  • Birmingham, AL
National Provider Identifier
1922425842
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
36909 Issued in AL
Practice address
1717 6TH Ave S
Birmingham, AL 35233-1801
Phone
(800) 822-8816
NPI assigned
Mar 28, 2014
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 36909 AL Primary

Addresses

Primary practice location

1717 6TH Ave S
Birmingham, AL 35233-1801

Mailing address

1717 6TH Ave S
Birmingham, AL 35233-1801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190618002645 AL Practitioner - Anesthesiology 1456685858 Reassigns benefits to 1 organization
I20251111003455 KY Practitioner - Anesthesiology 1456685858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 Nicholasville Rd
Lexington, KY 40503-1431
Phone (859) 268-1030

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36909ALMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 1, 2019 Accepting new patients
Central Kentucky Anesthesia PSC Anesthesiology CurrentSince Oct 1, 2025 Accepting new patients
Central Kentucky Anesthesia P.S.C. CurrentSince Oct 1, 2025 Accepting new patients

Locations

1717 6th Ave S
Birmingham, AL 35233
Phone (205) 934-3450

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

1740 Nicholasville Rd
Lexington, KY 40503
Phone (859) 260-6100

425 Lewis Hargett Cir
Lexington, KY 40503
Phone (606) 679-9322

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1922425842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331801",
            "telephone_number": "800-822-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDIS",
        "first_name": "DYLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-28",
        "last_updated": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "36909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.