NPIMap

Organization Active NPI

Cahaba Medical Care Foundation

  • Multi-Specialty Clinic/Center
  • Centreville, AL
National Provider Identifier
1093058133
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CAHABA MEDICAL CARE FOUNDATION
Practice address
294 Pierson Avenue
Centreville, AL 35042
Phone
(205) 926-2992
Fax
(205) 926-2993
NPI assigned
Mar 27, 2013
Last updated
Nov 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Authorized official

Name
Dr. John Bryan Waits, M.D.NPI 1962422337
Title
Ceo
Phone
(205) 926-2992

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
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

294 Pierson Avenue
Centreville, AL 35042

Mailing address

405 Belcher St
Centreville, AL 35042-2946
Phone (205) 926-2992

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121120000238 AL Part B Supplier - Clinic/Group Practice 1355597923 Receives reassigned benefits from 220 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Birmingham, AL; Tuscaloosa, AL; Northport, AL; Centreville, AL; Bessemer, AL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

101 Oslo Cir
Ste 1B
Birmingham, AL 35211
Phone (205) 944-3944

294 Pierson Ave
Centreville, AL 35042

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11347/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 55

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.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1093058133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BELCHER ST",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "350422946",
            "telephone_number": "205-926-2992",
            "fax_number": "205-926-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 PIERSON AVENUE",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "35042",
            "telephone_number": "205-926-2992",
            "fax_number": "205-926-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAHABA MEDICAL CARE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "WAITS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "205-926-2992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.