NPIMap

Organization Active NPI

United Doctors Family Medical Center LLC

  • Internal Medicine Physician
  • Boaz, AL
National Provider Identifier
1013313709
Registry record updated Nov 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00026230 Issued in AL
Legal business name
UNITED DOCTORS FAMILY MEDICAL CENTER LLC
Practice address
2986 US Highway 431
Boaz, AL 35957-5848
Phone
(256) 673-0977
NPI assigned
Nov 7, 2014
Last updated
Nov 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2014

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

Authorized official

Name
Enrico Gaspar, MDNPI 1497740492
Title
Physician
Phone
(256) 673-0977

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 00026230 AL Primary

Addresses

Primary practice location

2986 US Highway 431
Boaz, AL 35957-5848

Mailing address

2986 US Highway 431
Boaz, AL 35957-5848
Phone (256) 673-0977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150402000069 AL Part B Supplier - Clinic/Group Practice 0648597567 Receives reassigned benefits from 29 practitioners
Practice locations: Albertville, AL; Boaz, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2092216United Doctors Family Medical Center2986 US Hwy 431, Boaz, AL 35957Certificate of waiverMar 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
United Doctors Fam Med CR2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415318400000",
    "number": "1013313709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2986 US HIGHWAY 431",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575848",
            "telephone_number": "256-673-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2986 US HIGHWAY 431",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575848",
            "telephone_number": "256-673-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED DOCTORS FAMILY MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A",
        "authorized_official_last_name": "GASPAR",
        "authorized_official_first_name": "ENRICO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "256-673-0977",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00026230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boaz, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.