The Sylacauga Health Care Authority
Organization Active NPI Family Medicine Physician · Sylacauga, AL
NPI 1124235320 · NPPES record last updated Feb 9, 2012
Key facts
- NPI
- 1124235320
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 207Q00000X (AL)
- Legal business name
- THE SYLACAUGA HEALTH CARE AUTHORITY
- Practice address
- 315 W Hickory St
Sylacauga, AL 35150-2913 - Phone
- (256) 401-4000
- Fax
- (256) 401-4603
- NPI assigned
- May 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Janice G Brown
- Title
- Chief Financial Officer
- Phone
- (256) 401-4606
Owned or controlled facilities with NPI records 2
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 6
Practitioners 168
-
Mohamed Ammar Aldaher, M.D.
-
Khaleel K Ashraf, M.D.
-
Kevin Patrick Bevis, M.D.
-
Tasia Bates Bradford, CRNP
-
Juan Campos, M.D.
-
Timothy A. Crump, N.P
-
Renee S Davis, M.D.
-
Matthew Ryan Dimon, M.D.
-
Zachary Ian Edwards, CRNA
-
Clifton Garris, M.D.
-
Kay B. Hare, CRNA
-
Nancy Coleana Hill, FNP-BC
-
Elizabeth Kendall, CRNP, FNP
-
Davona Sheyvon Laurin, CRNP
-
Quincy Adam Leach, AGACNP
-
Stacey McGrady, NP
-
David James Mooney, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Coosa Valley Hospice |
Hospice | 5% Or Greater Direct Ownership Interest | Mar 8, 2007 |
| Nix Family Medicine |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jul 1, 2023 Jul 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
709 Ward Ave NE
Huntsville, AL 35801
Phone (256) 539-9471
126 S Anniston Ave
Sylacauga, AL 35150
Phone (256) 249-6050
122 S Anniston Ave
Sylacauga, AL 35150
Phone (256) 249-5800
110 S Anniston Ave
Sylacauga, AL 35150
Phone (256) 207-0200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 207Q00000X | AL | Yes |
| Surgery Physician |
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
- dba Coosa Valley Medical Center
Other providers in Sylacauga, AL
- Talladega County Health Dept-Sylacauga Prev Health Ed
- Talladega County Health Dept-Sylacauga Pri Care
- Talladega County Health Dept-Sylacauga VFC Immun
- Gloria Villasenor Talley
- Terri Tucker Robinette, LLC
- The Sylacauga Health Care Authority
- The Sylacauga Health Care Authority
- The Sylacauga Health Care Authority
- The Sylacauga Health Care Authority
- The Sylacauga Health Care Authority
All providers in Sylacauga, AL · Family Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.