Organization Active NPI

Innovative Healthcare, LLC

  • Pediatrics Physician
  • Dothan, AL
National Provider Identifier
1083361893
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
INNOVATIVE HEALTHCARE, LLC
Practice address
200 Grove Park LN Ste 660
Dothan, AL 36305-5922
Phone
(334) 791-6910
NPI assigned
Mar 2, 2022
Last updated
Mar 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Dr. Claude T Ashley Jr., MD, PHDNPI 1194722397
Title
Manager/ Physician
Phone
(334) 791-6910

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
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

200 Grove Park LN Ste 660
Dothan, AL 36305-5922

Mailing address

200 Grove Park LN Ste 660
Dothan, AL 36305-5922
Phone (334) 791-6910

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
01D2243664Innovative Healthcare LLC200 Grove Park Lane, Suite 660, Dothan, AL 36305Certificate of waiverNov 21, 2027

National Provider Directory

National Provider Directory

Locations

200 Grove Park Ln
Ste 660
Dothan, AL 36305
Phone (334) 791-6910

Practitioners & affiliated clinicians

Practitioners 1

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": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1083361893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GROVE PARK LN STE 660",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363055922",
            "telephone_number": "334-791-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GROVE PARK LN STE 660",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363055922",
            "telephone_number": "334-791-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "ASHLEY",
        "authorized_official_first_name": "CLAUDE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MANAGER/ PHYSICIAN",
        "authorized_official_telephone_number": "334-791-6910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.