NPIMap

Organization Active NPI

The Sylacauga Health Care Authority

Doing business as dba Coosa Valley Medical Center

  • Family Medicine Physician
  • Sylacauga, AL
National Provider Identifier
1124235320
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
207Q00000X Issued in AL
Legal business name
THE SYLACAUGA HEALTH CARE AUTHORITY
Doing business as
dba Coosa Valley Medical Center
Practice address
315 W Hickory St
Sylacauga, AL 35150-2913
Phone
(256) 401-4000
Fax
(256) 401-4603
NPI assigned
May 17, 2007
Last updated
Feb 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Authorized official

Name
Mrs. Janice G Brown
Title
Chief Financial Officer
Phone
(256) 401-4606

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 207Q00000X AL Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 208600000X AL

Addresses

Primary practice location

315 W Hickory St
Sylacauga, AL 35150-2913

Mailing address

315 W Hickory Street
Sylacauga, AL 35150-2913
Phone (256) 401-4070

Other names 1

  • dba Coosa Valley Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727001079 AL Part B Supplier - Clinic/Group Practice 5294710398 Receives reassigned benefits from 73 practitioners
3 other NPIs on this enrollment
Practice locations: Rockford, AL; Sylacauga, AL; Childersburg, AL

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

33733 US Highway 280
Childersburg, AL 35044
Phone (256) 378-3301

9518 US Highway 231
Rockford, AL 35136
Phone (256) 377-4366

11 N Norton Ave
Sylacauga, AL 35150
Phone (256) 245-6700

122 S Anniston Ave
Sylacauga, AL 35150
Phone (256) 249-5800

126 S Anniston Ave
Sylacauga, AL 35150
Phone (256) 249-6050

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Coosa Valley HospiceSylacauga, AL, CCN 011661 Hospice 5% Or Greater Direct Ownership Interest Mar 8, 2007
Nix Family MedicineChildersburg, AL, CCN 018503 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2023
Jul 1, 2023

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 168

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 168

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1124235320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W HICKORY STREET",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502913",
            "telephone_number": "256-401-4070",
            "fax_number": "256-401-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W HICKORY ST",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502913",
            "telephone_number": "256-401-4000",
            "fax_number": "256-401-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SYLACAUGA HEALTH CARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "256-401-4606",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "207Q00000X",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "AL",
            "license": "208600000X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Coosa Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sylacauga, AL

Sources for this page

Verify at the official NPI Registry.