Family Health Care Clinic, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Muscle Shoals, AL
NPI 1003049016 · NPPES record last updated Apr 16, 2020
Key facts
- NPI
- 1003049016
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- FAMILY HEALTH CARE CLINIC, INC
- Practice address
- 102 Physicians Dr
Suite B
Muscle Shoals, AL 35661 - Phone
- (601) 825-7280
- Fax
- (601) 825-8130
- NPI assigned
- Aug 25, 2009
- Organization subpart
- No
Authorized official
- Name
- Karina Marie Clayton
- Title
- Chief Financial Officer
- Phone
- (601) 825-7280
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 35
Facilities with the same owner 5
Practitioners 6
-
Elizabeth A Buffler, M.D.
-
Judy Ann Collier, CRNP
-
Marleah McAnalley, CRNP
-
Joel Alonzo Powell Jr., M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AL
Federally qualified health center certification: CCN 011970
- Legal name
- FAMILY HEALTH CARE CLINIC INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 16, 2010
- Last certification
- Mar 16, 2010
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 1, 1996 in MS
- Enrollment address
- 102 Physicians Dr
Ste B
Muscle Shoals, AL 35661-2149
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Margaret a Gray |
Corporate Director |
Aug 5, 2009 | |
| W-2 Managing Employee | Aug 5, 2009 | ||
| Michael Howard |
Corporate Director | Jul 21, 2009 | |
| Helen Johnson |
Corporate Director | Jul 21, 2009 | |
| Louise Patterson |
Corporate Director | Aug 28, 2009 | |
| Family Health Care Clinic Inc |
Operational/Managerial Control | Aug 1, 2009 | |
| Annie Posey |
Corporate Director |
Apr 1, 2022 | |
| Carolyn Hartzog |
Corporate Director | Aug 28, 2009 | |
| Cindy Bryan |
Corporate Director | Aug 28, 2009 | |
| Janet Alexander |
Corporate Director |
Apr 1, 2022 |
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Family Health Care Clinic Inc |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2009 |
| Family Health Care Clinic Inc |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2009 |
| Family Health Care Clinic Inc |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2009 |
| Family Health Care Clinic Inc |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2009 |
| Family Health Care Clinic Inc |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2009 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100318000658 | AL | Part a Provider - Federally Qualified Health Center (FQHC) | 5395656946 | Practice locations: Muscle Shoals, AL |
| O20100628001034 | AL | Part B Supplier - Clinic/Group Practice | 5395656946 |
Receives reassigned benefits from 22 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Russellville, AL; Town Creek, AL; Rogersville, AL; Muscle Shoals, AL; Florence, AL; Decatur, AL |
National Provider Directory
- Tax ID family
- Family Health Care Clin
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CFHGAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | AL | Yes |
Addresses
Primary practice location
102 Physicians Dr
Suite B
Muscle Shoals, AL 35661
Mailing address
PO Box 24116
Jackson, MS 39225-4116
Phone (601) 825-7280
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117988 | Medicaid | AL |
Other providers in Muscle Shoals, AL
- Holly Nicole Elgin
- Elizabeth Ann Dunaway, P.C.
- Ashley Elkabetz
- Sandra Lynn Embry
- Encore Rehabilitation Inc
- Family Practice Specialist, PC
- Muhammad Taha Farooq
- Caroline Parker Finch
- Allison Fisher
- Kendra Leigh Flanagan
All providers in Muscle Shoals, AL · Federally Qualified Health Center (FQHC) in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.