Aletheia House, Inc.
Organization Active NPI Family Nurse Practitioner · Bessemer, AL
NPI 1003270430 · NPPES record last updated Feb 23, 2017
Key facts
- NPI
- 1003270430
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- ALETHEIA HOUSE, INC.
- Practice address
- 2201 Arlington Ave
Bessemer, AL 35020-4221 - Phone
- (205) 324-6502
- NPI assigned
- Apr 12, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- ALETHEIA HOUSE
Authorized official
- Name
- Mr. Christopher W Retan
- Title
- Executive Director
- Phone
- (205) 324-6502
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 1
-
Max Michael III, M.D.
Corporate family (same tax ID) 1
Practitioners 7
-
Max Michael III, M.D.
-
Danisha Opoku, FNP-C
-
Lakisha C. Knight, CRNP , RN
-
Andrew Marc Friede, MD, MPH
-
Jordain Elaine Boland, MS, QMHP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2114284 | Bessemer Neighborhood Health Center | Certificate of waiver | Jun 9, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AL
Federally qualified health center certification: CCN 011032
- Legal name
- ALETHEIA HOUSE, INC.
- Doing business as
- BESSEMER NEIGHBORHOOD HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 31, 2017
- Last certification
- Mar 31, 2017
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Sep 5, 1972 in AL
- Enrollment address
- 2201 Arlington Ave
Bessemer, AL 35020-4221
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Robert Boswell |
Corporate Director |
Jan 23, 2017 | 5.26% |
| Walter Lee Robinson |
Corporate Director |
Jan 1, 2013 | 5.26% |
| Tlandra Nevett |
Corporate Officer |
Jan 1, 2022 | |
| Jennifer Rankin |
Corporate Director |
Jan 1, 2013 | 5.26% |
| Cynthia Rena Ramsey |
Corporate Director |
Jan 1, 1999 | 5.26% |
| Lauren Parker |
Corporate Director |
Jan 1, 2014 | 5.26% |
| Melvin Harris |
Corporate Director |
Jan 1, 2014 | 5.26% |
| Aletheia House, Inc. |
5% Or Greater Direct Ownership Interest | Sep 5, 1972 | 100% |
| Other | Sep 5, 1972 | 100% | |
| Miree Tolbert |
Corporate Director |
Jan 1, 2005 | 5.26% |
| Christopher Kramer |
Corporate Director |
Jan 1, 2001 | 5.26% |
| Roy Colson |
Corporate Director |
Jan 1, 1982 | 5.26% |
| Ruthie Dudley |
Corporate Director |
Jan 1, 2016 | 5.26% |
| Anoop Mishra |
Corporate Director |
Jan 1, 2008 | 5.26% |
| Liston Cook |
Corporate Director |
Jan 1, 2015 | 5.26% |
| Benjamin Blass |
Corporate Director |
Jan 1, 2013 | 5.26% |
| Carol Clarke |
Corporate Director |
Jan 1, 1999 | 5.26% |
| Corlene Morrow |
Corporate Director |
Jan 1, 1999 | 5.26% |
| Calvin Wilson |
Corporate Director |
Jan 1, 2014 | 5.26% |
| Kenneth Gulley |
Corporate Director |
Jan 1, 2014 | 5.26% |
| Perryn Suzanne Carroll |
Corporate Director |
Jan 1, 2014 | 5.26% |
| Max Michael |
Corporate Director |
Jan 1, 2015 | 5.26% |
| Christopher Retan |
Corporate Officer | Jan 23, 2017 | |
| W-2 Managing Employee |
Jan 23, 2017 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170214000963 | AL | Part a Provider - Federally Qualified Health Center (FQHC) | 3971886151 | Practice locations: Bessemer, AL |
| O20191031000663 | AL | Part B Supplier - Clinic/Group Practice | 3971886151 |
Receives reassigned benefits from 6 practitioners Practice locations: Bessemer, AL |
National Provider Directory
- Tax ID family
- Aletheia House
- Part of
- Aletheia House
Interoperability endpoints
- https://api.platform.athenahealth.com/15655/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Addiction Medicine (Internal Medicine) Physician |
207RA0401X | |||
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
2201 Arlington Ave
Bessemer, AL 35020-4221
Mailing address
PO Box 1514
Birmingham, AL 35201-1514
Phone (205) 324-6502
Other names
- Bessemer Neighborhood Health Center
Other providers in Bessemer, AL
- Alabama Head and Neck Clinic
- Alabama Pulmonary and Sleep Specialists, PC
- Alabama Radiologists PC
- Alabama Skin Institute, Inc
- Paul Joseph Albano Sr.
- Danielle Alexander
- Marianne Alfano-Dreyspring
- Muhammad Kalim Sadiq Ali
- Theresa Anntionette Ali
- All Heart Caregivers
All providers in Bessemer, AL · Family Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2017. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.