NPIMap

Organization Active NPI

Professional Medical Associates PC

  • Internal Medicine Physician
  • Enterprise, AL
National Provider Identifier
1063476836
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PROFESSIONAL MEDICAL ASSOCIATES PC
Practice address
101 E Brunson St
Suite 200
Enterprise, AL 36330
Phone
(334) 393-3686
Fax
(334) 347-4906
NPI assigned
Apr 17, 2006
Last updated
Jul 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Authorized official

Name
Melanie Senn, CPC
Title
Business Office Manager
Phone
(334) 393-3686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

101 E Brunson St
Suite 200
Enterprise, AL 36330

Mailing address

101 E Brunson St
Suite 200
Enterprise, AL 36330-2526
Phone (334) 393-3686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050822001085 AL Part B Supplier - Clinic/Group Practice 3375574106 Receives reassigned benefits from 18 practitioners
Practice locations: Enterprise, AL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0304937Professional Medical Associates101 East Brunson St Suite 200, Enterprise, AL 36330AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531094400000",
    "number": "1063476836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BRUNSON ST",
            "address_2": "SUITE 200",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302526",
            "telephone_number": "334-393-3686",
            "fax_number": "334-347-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BRUNSON ST",
            "address_2": "SUITE 200",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "36330",
            "telephone_number": "334-393-3686",
            "fax_number": "334-347-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2018-07-09",
        "status": "A",
        "authorized_official_last_name": "SENN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "334-393-3686",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; 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.