NPIMap

Organization Active NPI

Franklin Primary Health Center Inc

Doing business as West Mobile Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
National Provider Identifier
1154551703
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FRANKLIN PRIMARY HEALTH CENTER INC
Doing business as
West Mobile Family Medical Center
Practice address
801 University Blvd S Ste D
Mobile, AL 36609-2949
Phone
(251) 344-1964
Fax
(251) 344-2227
NPI assigned
Jul 16, 2009
Last updated
Aug 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANKLIN PRIMARY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Mr. Charles White
Title
Chief Executive Officer
Phone
(251) 432-4117

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Medical Specialty Clinic/Center 261QM2500X NU
Dentist 122300000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Ophthalmology Physician 207W00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Pediatrics Physician 208000000X NU
Body Imaging Physician 2085B0100X NU
Hospitalist Physician 208M00000X NU

Addresses

Primary practice location

801 University Blvd S Ste D
Mobile, AL 36609-2949

Mailing address

PO Box 2048
Mobile, AL 36652-2048
Phone (251) 432-4117

Other names 1

  • West Mobile Family Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040618000827 AL Part B Supplier - Clinic/Group Practice 1658356308 Receives reassigned benefits from 126 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mobile, AL; Prichard, AL; Uriah, AL; Frisco City, AL; Loxley, AL; Brewton, AL; Evergreen, AL; Foley, AL…
O20091231000489 AL Part A Provider - Federally Qualified Health Center (FQHC) 1658356308 Practice locations: Mobile, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154551703. Details of each certification follow.

Federally qualified health center certification: CCN 011964

Legal name
FRANKLIN PRIMARY HEALTH CENTER, INC.
Doing business as
WEST MOBILE FAMILY MEDICAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 4, 2010
Last certification
Jan 4, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 1998 in AL
Enrollment address
801 S University Blvd
Suite D
Mobile, AL 36609-2949

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory
Tax ID family
Frnaklin Primary Health25 organizations share this tax ID, including this one
Part of
Frnaklin Primary Health

Other organizations with this tax ID 24

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

View all 24

Locations

801 S University Blvd
Ste D
Mobile, AL 36609
Phone (251) 344-1964

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Myrtis Jones Individual Corporate Officer Sep 1, 2011
Myriam Brister Individual Corporate Officer Sep 1, 2011
Larry Coleman Individual Corporate Officer Sep 1, 2011
Yullia Edwards Individual Corporate Officer Sep 1, 2011
Chris McGadney Individual Corporate Officer Sep 1, 2011
Ronald Martin Individual Corporate Officer Sep 1, 2011
Herman Harville Individual Corporate Officer Sep 1, 2011
Rosa Hart Individual Corporate Officer Sep 1, 2011
Stan Chavis Individual Corporate Officer Sep 1, 2011
Lula Ifill Individual Corporate Officer Sep 1, 2011
Sydney Raine Individual Corporate Officer Sep 1, 2011
Charles White Individual 5% Or Greater Indirect Ownership InterestCeo Jan 1, 2022 5%
Corporate Officer Oct 19, 2012
Corporate Director Jul 1, 2009
W-2 Managing Employee Jul 1, 2009

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Foley School Based Health CenterFoley, AL, CCN 011028 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2016

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1247702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1154551703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2048",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366522048",
            "telephone_number": "251-432-4117",
            "fax_number": "251-964-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 UNIVERSITY BLVD S STE D",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366092949",
            "telephone_number": "251-344-1964",
            "fax_number": "251-344-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN PRIMARY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANKLIN PRIMARY HEALTH CENTER, INC.",
        "enumeration_date": "2009-07-16",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "251-432-4117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Mobile Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Mobile Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.