Fort Payne RHC Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

FORT PAYNE RHC CORP

Doing business as

Dekalb Clinic South

Practice address

13280 County Road 51
Collinsville, AL 35961-4174

Phone

(307) 782-7560

NPI assigned

Aug 9, 2017

Organization subpart

No

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

Authorized official

Name

Amber Morris

Title

Authorized Official

Phone

(256) 927-9162

Specialties & licenses 4

Addresses

Other names 1

• Dekalb Clinic South Doing business as

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4622/brand/1/csg/21/fhir/r4

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Fort Payne RHC Corp

  • Internal Medicine Physician
  • Fort Payne, AL
  • NPI 1184679938
  NPPES parent name

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502236800000",
    "number": "1013432244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ATLANTIC AVE",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633046",
            "telephone_number": "516-593-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13280 COUNTY ROAD 51",
            "city": "COLLINSVILLE",
            "state": "AL",
            "postal_code": "359614174",
            "telephone_number": "307-782-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT PAYNE RHC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-09",
        "last_updated": "2017-08-09",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "256-927-9162"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dekalb Clinic South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Co Co, Inc.
• Collinsville Express Drugs LLC
• Collinsville Nursing Home, Inc
• Dekalb Baptist Medical Center Home Health
• Fort Payne Clinic Corp
• Pamela Gibson, CRNP
• Misty Sharp Ingram, CRNP
• Sunil K Jaiswal, MD
• Judith Womack Jones, ARNP
• Kilgore Express Pharmcy Inc

• Internal Medicine Physician in Collinsville, AL
• Providers in Collinsville, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.