NPIMap

Organization Active NPI

Houston County Healthcare Authority

Doing business as CliniCare

  • Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1144469438
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-022372 Issued in AL
Legal business name
HOUSTON COUNTY HEALTHCARE AUTHORITY
Doing business as
CliniCare
Practice address
1806 Fairview Ave Ste a
Dothan, AL 36301-3026
Phone
(334) 793-8087
Fax
(334) 793-8191
NPI assigned
Feb 11, 2009
Last updated
Feb 11, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
HOUSTON COUNTY HEALTHCARE AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Authorized official

Name
Mr. Derek Miller
Title
Cfo
Phone
(334) 793-8087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 1-022372 AL Primary

Addresses

Primary practice location

1806 Fairview Ave Ste a
Dothan, AL 36301-3026

Mailing address

PO Box 578
Dothan, AL 36302-0578
Phone (334) 793-8087

Other names 1

  • CliniCare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000209 AL Part B Supplier - Clinic/Group Practice 9436062296 Receives reassigned benefits from 540 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dothan, AL; Elba, AL; Enterprise, AL; Eufaula, AL; Midland City, AL; Taylor, AL; Troy, AL; Ashford, AL

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Houston Coenterprise Med17 organizations share this tax ID, including this one
Part of
Houston Coenterprise Med

Other organizations with this tax ID 16

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

View all 16

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1144469438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 578",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363020578",
            "telephone_number": "334-793-8087",
            "fax_number": "334-793-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 FAIRVIEW AVE STE A",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013026",
            "telephone_number": "334-793-8087",
            "fax_number": "334-793-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON COUNTY HEALTHCARE AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSTON COUNTY HEALTHCARE AUTHORITY",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "334-793-8087",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-022372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CliniCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.