NPIMap

Organization Active NPI

Chilton Family Medicine, P.C.

  • Rural Health Clinic/Center
  • Thorsby, AL
National Provider Identifier
1073389003
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CHILTON FAMILY MEDICINE, P.C.
Practice address
14 Minnesota Ave
Thorsby, AL 35171
Phone
(256) 280-1010
NPI assigned
Nov 30, 2023
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Jeffrey F PriceNPI 1205884426
Title
Owner
Phone
(205) 280-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

14 Minnesota Ave
Thorsby, AL 35171

Mailing address

107 Health Center Dr
Clanton, AL 35045-2344
Phone (205) 280-1010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231222000216 AL Part A Provider - Rural Health Clinic 8426077199 Practice locations: Thorsby, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073389003. Details of each certification follow.

Rural health clinic certification: CCN 018974

Legal name
CHILTON FAMILY MEDICINE, P.C.
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 8, 2024
Last certification
Mar 15, 2024
Ownership / control type
Non-profit – church related
Organization structure
CorporationProprietary
Incorporated
Oct 5, 1999 in AL
Enrollment address
14 Minnesota Ave
Thorsby, AL 35171

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
01D2292598Chilton Family Medicine PC14 Minnesota Ave, Thorsby, AL 35171Certificate of waiverOct 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Chilton Family Medicine PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeffrey F Price Individual 5% Or Greater Direct Ownership InterestOwner Nov 5, 1999 100%
Brooke Lewis Individual W-2 Managing EmployeeOffice Manager Dec 6, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 5

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": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1073389003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 HEALTH CENTER DR",
            "city": "CLANTON",
            "state": "AL",
            "postal_code": "350452344",
            "telephone_number": "205-280-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MINNESOTA AVE",
            "city": "THORSBY",
            "state": "AL",
            "postal_code": "35171",
            "telephone_number": "256-280-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILTON FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-280-1010"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thorsby, AL

Sources for this page

Verify at the official NPI Registry.