NPI Record of ATMORE COMMUNITY HOSPITAL PROFESSIONAL GROUP (ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC) NPI 1356515449

Anesthesiologist Assistant in Atmore, AL

Complete NPI Record

Field Name Value Definition
NPI1356515449The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe last name of the provider. If the provider is an individual, this is the legal name.
Provider Organization Name Legal Business NameESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INCThe first name of the provider, if the provider is an individual.
Provider Other Organization NameATMORE COMMUNITY HOSPITAL PROFESSIONAL GROUPThe abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Organization Name Type Code5The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider First Line Business Mailing AddressPO BOX 17106The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NamePENSACOLAThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address State NameFLThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code325227106The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number8504692044The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Fax Number8504344683The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address401 MEDICAL PARK DRThe fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Business Practice Location Address City NameATMOREThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameALThe city name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code365023006The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2513686362The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number8504344683The fax number associated with the location address of the provider being identified.
Provider Enumeration Date4/18/2008The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date5/9/2016The date that a record was last updated or changed.
Authorized Official Last NameNIXThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameDOUGLASThe first name of the authorized official.
Authorized Official Middle NameMARKThe middle name of the authorized official.
Authorized Official Title or PositionPRESIDENT/CEOThe title or position of the authorized official.
Authorized Official Telephone Number2514352071The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1367H00000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 1H2702Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 101Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1AL
Other Provider Identifier Issuer 1LICENSE
Is Organization SubpartN
Healthcare Provider Taxonomy Group 1193200000X MULTI-SPECIALTY GROUP