Vester Health Center LLC

Organization Active NPI Internal Medicine Physician · Lafayette, AL

NPI 1043371883 · NPPES record last updated Dec 2, 2010

Key facts

NPI
1043371883
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
License
10617 (AL)
Legal business name
VESTER HEALTH CENTER LLC
Practice address
140 1St St SE
Lafayette, AL 36862-2304
Phone
(334) 864-7887
Fax
(334) 864-0460
NPI assigned
Dec 13, 2006
Organization subpart
No

Authorized official

Name
Dr. Terry Yvonne Vester, M.D. NPI 1396806121
Title
Co-Owner
Phone
(334) 864-7887

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0936090Vester Health Center
140 First Street Southeast, Lafayette, AL 36862
Provider-performed microscopyMar 29, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051024000511 AL Part B Supplier - Clinic/Group Practice 9739105289 Receives reassigned benefits from 2 practitioners
Practice locations: Lafayette, AL

National Provider Directory

Locations

140 1st St SE
Lafayette, AL 36862
Phone (334) 864-7887

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207Q00000X 11415 AL
Internal Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207R00000X 10617 AL Yes

Addresses

Primary practice location

140 1St St SE
Lafayette, AL 36862-2304

Mailing address

140 1St St SE
Lafayette, AL 36862-2304
Phone (334) 864-7887

Other identifiers

IdentifierTypeStateIssuer
529800230MedicaidAL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 2, 2010.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1043371883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 1ST ST SE",
            "city": "LAFAYETTE",
            "state": "AL",
            "postal_code": "368622304",
            "telephone_number": "334-864-7887",
            "fax_number": "334-864-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 1ST ST SE",
            "city": "LAFAYETTE",
            "state": "AL",
            "postal_code": "368622304",
            "telephone_number": "334-864-7887",
            "fax_number": "334-864-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VESTER HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "VESTER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "YVONNE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "334-864-7887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "11415",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "10617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529800230",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, AL

All providers in Lafayette, AL · Internal Medicine Physician in Alabama

Sources for this page

Verify at the official NPI Registry.