Organization Active NPI

Mobile Medicine of Alabama

Doing business as Thomas Family Medicine

  • Primary Care Clinic/Center
  • Fairfield, AL
National Provider Identifier
1053724252
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
1-107825 Issued in AL
Legal business name
MOBILE MEDICINE OF ALABAMA
Doing business as
Thomas Family Medicine
Practice address
7070 Aaron Aronov Drive
Suite 88
Fairfield, AL 35064
Phone
(205) 678-3708
Fax
(205) 449-2066
NPI assigned
Jun 5, 2014
Last updated
Mar 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Authorized official

Name
Takeshia Monique Dent, NURSE PRACTITIONER
Title
DNP, MSN, CCRN, Cme, FNP-C
Phone
(205) 718-2781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 1-107825 AL Primary

Addresses

Primary practice location

7070 Aaron Aronov Drive
Suite 88
Fairfield, AL 35064

Mailing address

7070 Aaron Aronov Drive
Suite 88
Fairfield, AL 35064
Phone (205) 678-3708

Other names 1

  • Thomas Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160817000809 AL Part B Supplier - Clinic/Group Practice 7315232246 Receives reassigned benefits from 1 practitioner
Practice locations: Fairfield, AL

National Provider Directory

National Provider Directory

Locations

7070 Aaron Aronov Dr
Ste 88
Fairfield, AL 35064
Phone (205) 678-3708

7070 Weibel Dr
Fairfield, AL 35064
Phone (205) 786-7600

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": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1053724252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7070 AARON ARONOV DRIVE",
            "address_2": "SUITE 88",
            "city": "FAIRFIELD",
            "state": "AL",
            "postal_code": "35064",
            "telephone_number": "205-678-3708",
            "fax_number": "205-449-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7070 AARON ARONOV DRIVE",
            "address_2": "SUITE 88",
            "city": "FAIRFIELD",
            "state": "AL",
            "postal_code": "35064",
            "telephone_number": "205-678-3708",
            "fax_number": "205-449-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDICINE OF ALABAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "DENT",
        "authorized_official_first_name": "TAKESHIA",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "DNP, MSN, CCRN, CME, FNP-C",
        "authorized_official_telephone_number": "205-718-2781",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AL",
            "license": "1-107825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.