NPIMap

Organization Active NPI

Ft Payne Careplus, LLC

  • Family Medicine Physician
  • Ft Payne, AL
National Provider Identifier
1073086922
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FT PAYNE CAREPLUS, LLC
Practice address
3000 Gault Ave North
Ft Payne, AL 35967
Phone
(256) 697-1012
NPI assigned
Jan 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Angela Vaughn
Title
Administrator
Phone
(256) 310-4941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3000 Gault Ave North
Ft Payne, AL 35967

Mailing address

3000 Gault Ave North
Ft Payne, AL 35967
Phone (256) 697-1012

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190409000639 AL Part B Supplier - Clinic/Group Practice 6709127392 Receives reassigned benefits from 9 practitioners
Practice locations: Fort Payne, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1073086922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 GAULT AVE NORTH",
            "city": "FT PAYNE",
            "state": "AL",
            "postal_code": "35967",
            "telephone_number": "256-697-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 GAULT AVE NORTH",
            "city": "FT PAYNE",
            "state": "AL",
            "postal_code": "35967",
            "telephone_number": "256-697-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FT PAYNE CAREPLUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-03",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-310-4941"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.