NPIMap

Organization Active NPI

Relias Emergency Medicine Specialists of Fayette, LLC

  • Emergency Medicine Physician
  • Fayette, AL
National Provider Identifier
1093201543
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
RELIAS EMERGENCY MEDICINE SPECIALISTS OF FAYETTE, LLC
Practice address
1653 Temple Ave N
Fayette, AL 35555-1314
Phone
(662) 432-4106
NPI assigned
Jul 9, 2018
Last updated
Oct 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Authorized official

Name
Jennifer Kathryn Wakeford
Title
Enterprise Cfo
Phone
(205) 901-5103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1653 Temple Ave N
Fayette, AL 35555-1314

Mailing address

PO Box 31485
Charlotte, NC 28231-1485
Phone (662) 432-4106

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180918001531 AL Part B Supplier - Clinic/Group Practice 6800147604 Receives reassigned benefits from 74 practitioners
Practice locations: Fayette, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 75

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 75

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1093201543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31485",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282311485",
            "telephone_number": "662-432-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 TEMPLE AVE N",
            "city": "FAYETTE",
            "state": "AL",
            "postal_code": "355551314",
            "telephone_number": "662-432-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIAS EMERGENCY MEDICINE SPECIALISTS OF FAYETTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-09",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "WAKEFORD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "ENTERPRISE CFO",
        "authorized_official_telephone_number": "205-901-5103"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayette, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.