NPIMap

Organization Active NPI

Community Hospital, Inc

  • Family Medicine Physician
  • Tallassee, AL
National Provider Identifier
1114982360
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY HOSPITAL, INC
Practice address
115 Herren Hill Rd
Tallassee, AL 36078-1276
Phone
(334) 283-3477
NPI assigned
Apr 19, 2006
Last updated
Jul 19, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HOSPITAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Mrs. Jane S Bellew
Title
Office Manager
Phone
(334) 286-3477

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

115 Herren Hill Rd
Tallassee, AL 36078-1276

Mailing address

115 Herren Hill Rd
Tallassee, AL 36078-1276
Phone (334) 283-3477

Other names 1

  • Tallassee Family Care Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421001819 AL Part B Supplier - Clinic/Group Practice 2062408487 Receives reassigned benefits from 82 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Notasulga, AL; Tuskegee, AL; Tallassee, AL

Other NPIs on the same Medicare enrollment 6

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

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
01D0689275Tallassee Family Care115 Herren Hill Road, Tallassee, AL 36078Certificate of waiverFeb 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
William L Poole MD13 organizations share this tax ID, including this one
Part of
William L Poole MD

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1114982360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HERREN HILL RD",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360781276",
            "telephone_number": "334-283-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HERREN HILL RD",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360781276",
            "telephone_number": "334-283-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HOSPITAL, INC",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "BELLEW",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-286-3477",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tallassee Family Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tallassee, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.