Organization Active NPI

Elgin Medical Center

  • Family Nurse Practitioner
  • Rogersville, AL
National Provider Identifier
1083164677
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-097505 Issued in AL
Legal business name
ELGIN MEDICAL CENTER
Practice address
2850 Highway 101
Rogersville, AL 35652-6046
Phone
(256) 247-5792
Fax
(256) 247-5791
NPI assigned
Oct 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Authorized official

Name
Marissa RamseyNPI 1831423656
Title
Owner/ Practitioner
Phone
(256) 247-5792

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1-097505 AL Primary

Addresses

Primary practice location

2850 Highway 101
Rogersville, AL 35652-6046

Mailing address

2850 Highway 101
Rogersville, AL 35652-6046

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170209000095 AL Part B Supplier - Clinic/Group Practice 0840573234 Receives reassigned benefits from 1 practitioner
Practice locations: Rogersville, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1083164677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 HIGHWAY 101",
            "city": "ROGERSVILLE",
            "state": "AL",
            "postal_code": "356526046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 HIGHWAY 101",
            "city": "ROGERSVILLE",
            "state": "AL",
            "postal_code": "356526046",
            "telephone_number": "256-247-5792",
            "fax_number": "256-247-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "RAMSEY",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER/ PRACTITIONER",
        "authorized_official_telephone_number": "256-247-5792"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-097505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.