NPIMap

Organization Active NPI

Pickens County Medical Center Inc

  • General Acute Care Hospital
  • Carrollton, AL
National Provider Identifier
1164423679
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
10402 Issued in AL
Legal business name
PICKENS COUNTY MEDICAL CENTER INC
Practice address
241 R K Wilson Drive
Carrollton, AL 35447-0478
Phone
(205) 367-2408
Fax
(205) 367-9123
NPI assigned
Aug 9, 2005
Last updated
Jan 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Authorized official

Name
Mr. H Wayne McElroy
Title
Administrator
Phone
(205) 367-8111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 10402 AL Primary

Addresses

Primary practice location

241 R K Wilson Drive
Carrollton, AL 35447-0478

Mailing address

PO Box 478
Carrollton, AL 35447-0478
Phone (205) 367-2408

Other identifiers 4

IdentifierTypeStateIssuer
510C682OtherALBLUE SHIELD
558200610MedicaidAL
HOS0109HMedicaidAL
010129OtherALBCBS

National Provider Directory

National Provider Directory
Tax ID family
Reform Primary Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

241 Robert K Wilson Dr
#R
Carrollton, AL
Phone (205) 367-2408

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": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358208000000",
    "number": "1164423679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 478",
            "city": "CARROLLTON",
            "state": "AL",
            "postal_code": "354470478",
            "telephone_number": "205-367-2408",
            "fax_number": "205-367-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 R K WILSON DRIVE",
            "city": "CARROLLTON",
            "state": "AL",
            "postal_code": "354470478",
            "telephone_number": "205-367-2408",
            "fax_number": "205-367-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICKENS COUNTY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-01-15",
        "status": "A",
        "authorized_official_last_name": "MCELROY",
        "authorized_official_first_name": "H",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "205-367-8111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AL",
            "license": "10402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "510C682",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "558200610",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0109H",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010129",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.