Organization Active NPI

Greater Huntsville Family Practice

  • Family Medicine Physician
  • Huntsville, AL
National Provider Identifier
1073636650
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GREATER HUNTSVILLE FAMILY PRACTICE
Practice address
2089 Cecil Ashburn Drive
Suite 101
Huntsville, AL 35802
Phone
(256) 882-5060
Fax
(256) 882-9990
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Randle T Middleton, MD
Title
Owner
Phone
(256) 882-5060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2089 Cecil Ashburn Drive
Suite 101
Huntsville, AL 35802

Mailing address

2089 Cecil Ashburn Drive
Suite 101
Huntsville, AL 35802
Phone (256) 882-5060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051024000800 AL Part B Supplier - Clinic/Group Practice 3971529462 Receives reassigned benefits from 1 practitioner
Practice locations: Huntsville, AL

National Provider Directory

National Provider Directory
Tax ID family
Greater Huntsville Fam Practic2 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.

Practitioners & affiliated clinicians

Practitioners 2

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": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073636650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 CECIL ASHBURN DRIVE",
            "address_2": "SUITE 101",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35802",
            "telephone_number": "256-882-5060",
            "fax_number": "256-882-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 CECIL ASHBURN DRIVE",
            "address_2": "SUITE 101",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35802",
            "telephone_number": "256-882-5060",
            "fax_number": "256-882-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER HUNTSVILLE FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "RANDLE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-882-5060",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.