Organization Active NPI

Colon & Rectal Surgical Associates of Birmingham, P.C.

  • Specialist
  • Homewood, AL
National Provider Identifier
1972558864
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
15312 & 23439 Issued in AL
Legal business name
COLON & RECTAL SURGICAL ASSOCIATES OF BIRMINGHAM, P.C.
Practice address
3400 Independence Dr
Homewood, AL 35209-5604
Phone
(205) 933-1199
Fax
(866) 491-5373
NPI assigned
May 23, 2006
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Dr. Brian Truett Guffin, M.D.,F.A.C.S.NPI 1497704803
Title
President
Phone
(205) 933-1199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 15312 & 23439 AL Primary

Addresses

Primary practice location

3400 Independence Dr
Homewood, AL 35209-5604

Mailing address

3400 Independence Dr
Homewood, AL 35209-5604
Phone (205) 933-1199

Other identifiers 1

IdentifierTypeStateIssuer
529924730MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050705000939 AL Part B Supplier - Clinic/Group Practice 3476599051 Receives reassigned benefits from 2 practitioners
Practice locations: Fultondale, AL; Gardendale, AL; Homewood, AL

National Provider Directory

National Provider Directory

Locations

2213 Decatur Hwy
Gardendale, AL 35071
Phone (205) 264-2816

3400 Independence Dr
Homewood, AL 35209
Phone (205) 868-4086

5295 Preserve Pkwy
Hoover, AL 35244
Phone (205) 623-5529

Practitioners & affiliated clinicians

Practitioners 3

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": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1972558864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 INDEPENDENCE DR",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352095604",
            "telephone_number": "205-933-1199",
            "fax_number": "866-491-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 INDEPENDENCE DR",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352095604",
            "telephone_number": "205-933-1199",
            "fax_number": "866-491-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLON & RECTAL SURGICAL ASSOCIATES OF BIRMINGHAM, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "GUFFIN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "TRUETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-933-1199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,F.A.C.S."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "15312 & 23439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529924730",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.