Organization Active NPI

American Family Care, LLC

  • General Practice Physician
  • Chelsea, AL
National Provider Identifier
1134907439
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
AMERICAN FAMILY CARE, LLC
Practice address
12375 Chelsea Rd
Chelsea, AL 35043-3524
Phone
(205) 577-6401
Fax
(205) 677-6461
NPI assigned
Sep 18, 2023
Last updated
Mar 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Randy Johansen
Title
President
Phone
(205) 421-2101

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary
Clinic/Center 261Q00000X NU
Primary Care Clinic/Center 261QP2300X NU
Urgent Care Clinic/Center 261QU0200X NU

Addresses

Primary practice location

12375 Chelsea Rd
Chelsea, AL 35043-3524

Mailing address

3700 Cahaba Beach Rd
Birmingham, AL 35242-5225
Phone (205) 403-8902

Other identifiers 1

IdentifierTypeStateIssuer
529202590MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031229000157 AL Part B Supplier - Clinic/Group Practice 9739087818 Receives reassigned benefits from 704 practitioners
This NPI is an additional NPI on the enrollment

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
01D2293836American Family Care - Chelsea12375 Chelsea Road, Suite 100, Chelsea, AL 35043Certificate of waiverAug 29, 2026

National Provider Directory

National Provider Directory
Tax ID family
Amer Famcare Med CT Montg31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1134907439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CAHABA BEACH RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425225",
            "telephone_number": "205-403-8902",
            "fax_number": "205-271-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12375 CHELSEA RD",
            "city": "CHELSEA",
            "state": "AL",
            "postal_code": "350433524",
            "telephone_number": "205-577-6401",
            "fax_number": "205-677-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-421-2101"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529202590",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.