NPIMap

Organization Active NPI

Physicians Care of Clarke

  • Federally Qualified Health Center (FQHC)
  • Thomasville, AL
National Provider Identifier
1043987415
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PHYSICIANS CARE OF CLARKE
Practice address
33650 Highway 43
Thomasville, AL 36784-3305
Phone
(334) 636-5311
NPI assigned
Aug 24, 2021
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Farrell A Turner
Title
Ceo
Phone
(256) 201-0095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

33650 Highway 43
Thomasville, AL 36784-3305

Mailing address

24B Camden Byp
Camden, AL 36726-1770
Phone (334) 882-1919

Other practice location 1

33621 Hwy 43
Thomasville, AL 36784-3309
Phone (334) 636-5311

Other names 1

  • aka Physicians Care of Thomasville Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210921001942 AL Part B Supplier - Clinic/Group Practice 2961809736 Receives reassigned benefits from 10 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sweet Water, AL; Thomasville, AL; Grove Hill, AL; Fulton, AL; Camden, AL; Butler, AL
O20211026001613 AL Part A Provider - Federally Qualified Health Center (FQHC) 2961809736 Practice locations: Thomasville, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043987415. Details of each certification follow.

Federally qualified health center certification: CCN 011087

Legal name
PHYSICIANS CARE OF CLARKE
Doing business as
PHYICIANS CARE OF THOMASVILLE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 22, 2021
Last certification
Sep 22, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 20, 2018 in AL
Enrollment address
33650 Highway 43
Thomasville, AL 36784-3305

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Aka Fulton Family Medical5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Michael Paul Norris Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Doris L Morris Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Ricky L Powell Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Shirley Robison Crowe Individual Corporate DirectorBoard Member Dec 19, 2022
Operational/Managerial ControlBoard Member Dec 19, 2022
William Robertson Phillippi Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Farrell a. Turner Individual Corporate OfficerCeo Apr 20, 2020
W-2 Managing EmployeeCeo Apr 20, 2020
Operational/Managerial ControlCeo Apr 20, 2020 100%
Dwight Dwayne Figgers Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Larry Colston Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Steven Brent Megginson Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1043987415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24B CAMDEN BYP",
            "city": "CAMDEN",
            "state": "AL",
            "postal_code": "367261770",
            "telephone_number": "334-882-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33650 HIGHWAY 43",
            "city": "THOMASVILLE",
            "state": "AL",
            "postal_code": "367843305",
            "telephone_number": "334-636-5311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33621 HWY 43",
            "address_purpose": "LOCATION",
            "city": "THOMASVILLE",
            "state": "AL",
            "postal_code": "367843309",
            "country_code": "US",
            "telephone_number": "334-636-5311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIANS CARE OF CLARKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "FARRELL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-201-0095"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "aka Physicians Care of Thomasville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Thomasville, AL

Sources for this page

Verify at the official NPI Registry.