NPIMap

Organization Active NPI

Archwell Health Professional Services of Alabama, LLC

  • Internal Medicine Physician
  • Midfield, AL
National Provider Identifier
1033792502
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ARCHWELL HEALTH PROFESSIONAL SERVICES OF ALABAMA, LLC
Practice address
165 Bessemer Super Hwy
Midfield, AL 35228-2101
Phone
(205) 336-1534
Fax
(205) 498-2677
NPI assigned
May 3, 2021
Last updated
Mar 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Amy Moddesette
Title
Senior Director, Managed Care
Phone
(629) 224-1614

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X
Internal Medicine Physician 207R00000X Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X

Addresses

Primary practice location

165 Bessemer Super Hwy
Midfield, AL 35228-2101

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250

Other practice location 1

2232 Eastern Blvd
Montgomery, AL 36117-1555
Phone (334) 893-0344

Other practice location 2

3209 Ensley 5 Points W Ave
Birmingham, AL 35208-2715
Phone (659) 903-4344

Other practice location 3

9174 Parkway E
Birmingham, AL 35206-1507
Phone (205) 498-2675

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210812000554 AL Part B Supplier - Clinic/Group Practice 1254735277 Receives reassigned benefits from 30 practitioners
Practice locations: Birmingham, AL; Midfield, AL; Montgomery, 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
01D2316855Archwell Health Professional Services of Alabama2232 Eastern Blvd, Montgomery, AL 36117Certificate of waiverJan 13, 2027

National Provider Directory

National Provider Directory

Locations

2232 Eastern Blvd
Montgomery, AL 36117
Phone (334) 893-0344

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1033792502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 BESSEMER SUPER HWY",
            "city": "MIDFIELD",
            "state": "AL",
            "postal_code": "352282101",
            "telephone_number": "205-336-1534",
            "fax_number": "205-498-2677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2232 Eastern Blvd",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361171555",
            "country_code": "US",
            "telephone_number": "334-893-0344",
            "fax_number": "877-550-2086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3209 Ensley 5 Points W Ave",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352082715",
            "country_code": "US",
            "telephone_number": "659-903-4344",
            "fax_number": "659-903-4346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9174 Parkway E",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352061507",
            "country_code": "US",
            "telephone_number": "205-498-2675",
            "fax_number": "205-498-2676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARCHWELL HEALTH PROFESSIONAL SERVICES OF ALABAMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-03",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "MODDESETTE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, MANAGED CARE",
        "authorized_official_telephone_number": "629-224-1614"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midfield, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.