Custom Family Care, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CUSTOM FAMILY CARE, LLC

Doing business as

Custom Family Care

Practice address

279 Hughes Rd
Madison, AL 35758-1142

Phone

(256) 289-1733

NPI assigned

Aug 31, 2017

Organization subpart

No

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

Authorized official

Name

Ivan Pivovarov, MD

Title

President

Phone

(256) 325-0480

Specialties & licenses 2

Addresses

Other names 1

• Custom Family Care Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Dawn Marie Morris, CRNP, FNP-C

  • Family Medicine Physician
  • Athens, AL
  • NPI 1598464307
  Medicare reassignment NPD

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1053839811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 HUGHES RD",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 HUGHES RD",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581142",
            "telephone_number": "256-289-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-31",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "PIVOVAROV",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-325-0480",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Custom Family Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Custom Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cureme Clinic LLC
• Janice Wedge Currey II, LCSW
• Cassandra Joe Curry
• David Kennon Curtis Jr., D.M.D.
• Laurel Custer
• D. Kennon Curtis Jr. DMD PC
• Melissa D'Angelis, LICSW
• Joseph M. Dai III, M.D.
• Amber Rose Dallman, LCSW
• Nesline Damas

• Family Medicine Physician in Madison, AL
• Providers in Madison, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.