NPIMap

Organization Active NPI

East Alabama Ear, Nose, & Throat, PC

  • Otolaryngology Physician
  • Opelika, AL
National Provider Identifier
1942228655
Registry record updated Feb 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
17818 Issued in AL
Legal business name
EAST ALABAMA EAR, NOSE, & THROAT, PC
Practice address
1965 1St Ave
Opelika, AL 36801-5403
Phone
(334) 705-0012
Fax
(334) 705-0378
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2010

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

Authorized official

Name
Mr. William Raymond Blythe, M.D.NPI 1851321053
Title
President
Phone
(334) 705-0012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 17818 AL Primary

Addresses

Primary practice location

1965 1St Ave
Opelika, AL 36801-5403

Mailing address

1965 1St Ave
Opelika, AL 36801-5403
Phone (334) 705-0012

Other identifiers 4

IdentifierTypeStateIssuer
1851321053OtherALNPI FOR DR. BLYTHE
1255363008OtherALNPI FOR DR. STILES
1740214626OtherALNPI FOR DR. WHATLEY
529402350MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050721000531 AL Part B Supplier - Clinic/Group Practice 0749217776 Receives reassigned benefits from 13 practitioners
Practice locations: Opelika, AL

National Provider Directory

National Provider Directory

Locations

1773 Platt Pl
Montgomery, AL 36117
Phone (334) 272-8644

1965 1st Ave
Opelika, AL 36801
Phone (334) 705-0012

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266537600000",
    "number": "1942228655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 1ST AVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015403",
            "telephone_number": "334-705-0012",
            "fax_number": "334-705-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 1ST AVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015403",
            "telephone_number": "334-705-0012",
            "fax_number": "334-705-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST ALABAMA EAR, NOSE, & THROAT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2010-02-19",
        "status": "A",
        "authorized_official_last_name": "BLYTHE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-705-0012",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "17818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR DR. BLYTHE",
            "identifier": "1851321053",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR DR. STILES",
            "identifier": "1255363008",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR DR. WHATLEY",
            "identifier": "1740214626",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529402350",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelika, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; 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.