Mark E Ponder, M.D.
Individual provider Active NPI Family Medicine Physician · Lincoln, AL
NPI 1023047529 · NPPES record last updated Jul 11, 2024
Key facts
- NPI
- 1023047529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 00024336 (AL)
- Practice address
- 1100 Patton Chapel Rd
Lincoln, AL 35096 - Phone
- (205) 763-1414
- Fax
- (205) 763-1447
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Alabama School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lincoln Family Practice PC
Practice addresses (Care Compare)
1100 Patton Chapel Rd
Lincoln, AL 35096-4723
Phone (205) 763-1414
Hospital & facility affiliations
- Compassus Home Health
- St Vincent'S St Clair
- Citizens Baptist Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060214000383 | AL | Practitioner - Family Practice | 2860407889 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00024336 | AL | MD | Family Medicine Physician |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln Family Practice PC | Current |
Accepting new patients | |
| Eastside Ventures, Inc. | Family Medicine | Past | Accepting new patients |
Locations
1100 Patton Chapel Rd
Lincoln, AL 35096
Phone (205) 763-1414
Networks
- FL PPO
- MS PPO D-SNP
- MS PPO
- MS PPO C-SNP
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EDHHAA/Endpoint/EDHHAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 00024336 | AL | Yes |
Addresses
Primary practice location
1100 Patton Chapel Rd
Lincoln, AL 35096
Mailing address
1100 Patton Chapel Rd
Lincoln, AL 35096
Phone (205) 763-1414
Other providers in Lincoln, AL
- Anna Nelson
- Occupational Health Centers of the Southwest P.a.
- Occupational Health Centers of the Southwest P.a.
- Paradigm ABA, LLC
- April L Ponder
- Misty Lawley Ralyea
- Rehab and Wellness LLC
- Rejenerate Health LLC
- Revive Health Solutions, LLC
- Lauren Rodgers
All providers in Lincoln, AL · Family Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2024. 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.
- Order and Referring (CMS).
- 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.