Organization Active NPI

Parkway Family Practice

  • Family Medicine Physician
  • Moody, AL
National Provider Identifier
1063601094
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PARKWAY FAMILY PRACTICE
Practice address
2834 Moody Pkwy
Moody, AL 35004-3101
Phone
(205) 640-2808
Fax
(205) 640-2810
NPI assigned
Oct 16, 2007
Last updated
May 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Authorized official

Name
Dr. John Raines, D.O.
Title
Physician
Phone
(205) 640-2808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2834 Moody Pkwy
Moody, AL 35004-3101

Mailing address

2834 Moody Pkwy
Moody, AL 35004-3101
Phone (205) 640-2808

Other identifiers 1

IdentifierTypeStateIssuer
529912430MedicaidAL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1063601094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 MOODY PKWY",
            "city": "MOODY",
            "state": "AL",
            "postal_code": "350043101",
            "telephone_number": "205-640-2808",
            "fax_number": "205-640-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2834 MOODY PKWY",
            "city": "MOODY",
            "state": "AL",
            "postal_code": "350043101",
            "telephone_number": "205-640-2808",
            "fax_number": "205-640-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "RAINES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "205-640-2808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529912430",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moody, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.