NPIMap

Organization Active NPI

Franklin Primary Health Center, Inc.

Doing business as Gilbertown Medical Center

  • Federally Qualified Health Center (FQHC)
  • Gilbertown, AL
National Provider Identifier
1093775918
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FRANKLIN PRIMARY HEALTH CENTER, INC.
Doing business as
Gilbertown Medical Center
Practice address
140 Front Street
Suite 4
Gilbertown, AL 36908
Phone
(251) 843-5537
Fax
(251) 436-7765
NPI assigned
Mar 24, 2006
Last updated
Aug 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANKLIN PRIMARY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Mr. Charles White
Title
Chief Executive Officer
Phone
(251) 432-4117

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X
Dental Hygienist 124Q00000X
Dental Assistant 126800000X
Optometrist 152W00000X
Low Vision Rehabilitation Optometrist 152WL0500X
Pediatric Optometrist 152WP0200X
Sports Vision Optometrist 152WS0006X
Vision Therapy Optometrist 152WV0400X
Family Medicine Physician 207Q00000X
Adult Medicine Physician 207QA0505X
Geriatric Medicine (Family Medicine) Physician 207QG0300X
Internal Medicine Physician 207R00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

140 Front Street
Suite 4
Gilbertown, AL 36908

Mailing address

PO Box 2048
Mobile, AL 36652-2048
Phone (251) 434-8177

Other identifiers 2

IdentifierTypeStateIssuer
Q727OtherALBCBS
630011014MedicaidAL

Other names 1

  • Gilbertown Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040618000827 AL Part B Supplier - Clinic/Group Practice 1658356308 Receives reassigned benefits from 126 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mobile, AL; Prichard, AL; Uriah, AL; Frisco City, AL; Loxley, AL; Brewton, AL; Evergreen, AL; Foley, AL…
O20100729000972 AL Part A Provider - Federally Qualified Health Center (FQHC) 1658356308 Practice locations: Gilbertown, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093775918. Details of each certification follow.

Federally qualified health center certification: CCN 011913

Legal name
FRANKLIN PRIMARY HEALTH CENTER, INC.
Doing business as
GILBERTOWN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 2, 2001
Last certification
Oct 2, 2001
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jan 31, 1975 in AL
Enrollment address
140 Front St
Ste 4
Gilbertown, AL 36908-5510

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory
Part of
Franklin Memorial Prima

Locations

140 Front St
#4
Gilbertown, AL 36908
Phone (251) 276-2944

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tyrone Fenderson Individual Corporate OfficerBoard Member Aug 31, 2010
Myrtis Jones Individual Corporate OfficerBoard Member Jan 1, 2019
Myriam Brister Individual Corporate OfficerBoard Member Jan 1, 2019
Almeda Robinson Individual Corporate OfficerBoard Member Jan 1, 2019
Allison Kahalley Individual Corporate OfficerBoard Member Jan 1, 2019
Chris McGadney Individual Corporate OfficerBaord Member Jan 1, 2019
Ronald Martin Individual Corporate OfficerBoard Member Aug 31, 2010
Herman Harville Individual Corporate OfficerBoard Member Jan 1, 2019
Stan Chavis Individual Corporate OfficerBoard Member Jan 1, 2019
Anquayetta Fore Individual Corporate OfficerBoard Member Jan 1, 2019
Lula Ifill Individual Corporate OfficerBoard Member Jan 1, 2019
Sydney Raine Individual Corporate OfficerBoard Member Jan 1, 2019
Sondora Leverett Individual Corporate OfficerBoard Member Jan 1, 2019
Charles White Individual Corporate DirectorCeo Aug 31, 2010
W-2 Managing EmployeeCeo Aug 31, 2010
Taylor H Hodge Individual Corporate OfficerBoard Member Jan 1, 2019

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Foley School Based Health CenterFoley, AL, CCN 011028 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1093775918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2048",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366522048",
            "telephone_number": "251-434-8177",
            "fax_number": "251-436-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 FRONT STREET",
            "address_2": "SUITE 4",
            "city": "GILBERTOWN",
            "state": "AL",
            "postal_code": "36908",
            "telephone_number": "251-843-5537",
            "fax_number": "251-436-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN PRIMARY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANKLIN PRIMARY HEALTH CENTER, INC.",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "251-432-4117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Q727",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630011014",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gilbertown Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gilbertown Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilbertown, AL

Sources for this page

Verify at the official NPI Registry.