NPIMap

Organization Active NPI

Med Plus, Inc

Doing business as Med Plus Florence

  • Family Medicine Physician
  • Florence, AL
National Provider Identifier
1164408571
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MED PLUS, INC
Doing business as
Med Plus Florence
Practice address
2908 Mall Dr
Florence, AL 35630-1534
Phone
(256) 767-2702
Fax
(256) 718-6047
NPI assigned
Dec 16, 2005
Last updated
Feb 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Dustin Grutzik
Title
Business Manager
Phone
(256) 767-2702

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

2908 Mall Dr
Florence, AL 35630-1534

Mailing address

2908 Mall Dr
Florence, AL 35630-1534
Phone (256) 767-2702

Other names 1

  • Med Plus Florence Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051028000891 AL Part B Supplier - Clinic/Group Practice 7911924931 Receives reassigned benefits from 8 practitioners
Practice locations: Florence, AL

National Provider Directory

National Provider Directory

Locations

2908 Mall Rd
Florence, AL 35630
Phone (256) 767-2702

Practitioners & affiliated clinicians

Practitioners 10

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": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1164408571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 MALL DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301534",
            "telephone_number": "256-767-2702",
            "fax_number": "256-760-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 MALL DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301534",
            "telephone_number": "256-767-2702",
            "fax_number": "256-718-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED PLUS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "GRUTZIK",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "256-767-2702"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Plus Florence",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Plus Florence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.