NPIMap

Organization Active NPI

Franklin Primary Health Center, Inc.

Doing business as Franklin's Wellness, Smiles & Vision Express

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
National Provider Identifier
1043794480
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FRANKLIN PRIMARY HEALTH CENTER, INC.
Doing business as
Franklin's Wellness, Smiles & Vision Express
Practice address
1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341
Phone
(251) 432-4117
Fax
(251) 436-7765
NPI assigned
Sep 21, 2018
Last updated
Aug 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANKLIN PRIMARY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Charles N/a White
Title
Ceo
Phone
(251) 432-4117

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Dentist 122300000X NU
Nutritionist 133N00000X NU
Optometrist 152W00000X NU
Pharmacist 183500000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Ophthalmology Physician 207W00000X NU
Pediatrics Physician 208000000X NU
Body Imaging Physician 2085B0100X NU
Physical Therapist 225100000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Nurse Practitioner 363L00000X NU
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341

Mailing address

PO Box 2048
Mobile, AL 36652-2048
Phone (251) 432-4117

Other names 1

  • Franklin's Wellness, Smiles & Vision Express Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040618000827 AL Part B Supplier - Clinic/Group Practice 1658356308 Receives reassigned benefits from 126 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mobile, AL; Prichard, AL; Uriah, AL; Frisco City, AL; Loxley, AL; Brewton, AL; Evergreen, AL; Foley, AL…
O20191120000672 AL Part A Provider - Federally Qualified Health Center (FQHC) 1658356308 Practice locations: Mobile, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043794480. Details of each certification follow.

Federally qualified health center certification: CCN 011067

Legal name
FRANKLIN PRIMARY HEALTH CENTER, INC.
Doing business as
FRANKLIN'S WELLNESS, SMILES, VISION EXPRESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 20, 2019
Last certification
Nov 20, 2019
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jan 31, 1975 in AL
Enrollment address
1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory
Tax ID family
Franklin Memorial Prima25 organizations share this tax ID, including this one
Part of
Franklin Memorial Prima

Other organizations with this tax ID 24

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

View all 24

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tyrone Fenderson Individual Corporate OfficerBoard Member Jan 1, 2019
Myrtis Jones Individual Corporate OfficerBoard Member Jan 1, 2019
Myriam Brister Individual Corporate OfficerBoard Member Jan 1, 2019
Almeda Robinson Individual Corporate OfficerBoard Member Jan 1, 2019
Allison Kahalley Individual Corporate OfficerBoard Member Jan 1, 2019
Chris McGadney Individual Corporate OfficerBoard Member Jan 1, 2019
Ronald Martin Individual Corporate OfficerBoard Member Jan 1, 2019
Herman Harville Individual Corporate OfficerBoard Member Jan 1, 2019
Stan Chavis Individual Corporate OfficerBoard Member Jan 1, 2019
Anquayetta Fore Individual Corporate OfficerBoard Member Jan 1, 2019
Lula Ifill Individual Corporate OfficerBoard Member Jan 1, 2019
Sydney Raine Individual Corporate OfficerBoard Member Jan 1, 2019
Sondora Leverett Individual Corporate OfficerBoard Member Jan 1, 2019
Charles White Individual Corporate DirectorCeo Sep 21, 2018
W-2 Managing EmployeeCeo Sep 21, 2018
Taylor H Hodge Individual Corporate OfficerBoard Member Jan 1, 2019

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Foley School Based Health CenterFoley, AL, CCN 011028 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1043794480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2048",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366522048",
            "telephone_number": "251-432-4117",
            "fax_number": "251-436-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 DR MARTIN L KING JR AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035341",
            "telephone_number": "251-432-4117",
            "fax_number": "251-436-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN PRIMARY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANKLIN PRIMARY HEALTH CENTER, INC.",
        "enumeration_date": "2018-09-21",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "N/A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "251-432-4117"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Franklin's Wellness, Smiles & Vision Express",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.