Cullman Primary Care, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CULLMAN PRIMARY CARE, PC

Practice address

1800 Al Highway 157 Ste 100
Cullman, AL 35058

Phone

(256) 739-4131

Fax

(256) 739-6027

NPI assigned

Jun 15, 2010

Organization subpart

Yes

Parent organization

CULLMAN PRIMARY CARE, PCAs reported in NPPES

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

Authorized official

Name

Mrs. Connie Blankenship

Title

Credentialing Coordinator

Phone

(256) 739-0801

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Cullman Primary Care PC

Locations

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1164743068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 CLARK ST NE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350551921",
            "telephone_number": "256-739-0801",
            "fax_number": "256-739-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 AL HIGHWAY 157 STE 100",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "35058",
            "telephone_number": "256-739-4131",
            "fax_number": "256-739-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULLMAN PRIMARY CARE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CULLMAN PRIMARY CARE, PC",
        "enumeration_date": "2010-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "256-739-0801",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117960",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cullman Pain and Wellness LLC
• Cullman Pediatrics, Inc.
• Cullman Physical Medicine, P.C.
• Cullman Physical Therapy, LLC
• Cullman Primary Care, PC
• Cullman Primary Care, PC
• Cullman Primary Care, PC
• Cullman Primary Care, PC
• Cullman Psychiatry & Wellness, LLC
• Cullman Radiation Therapy Services, P.C.

• Family Medicine Physician in Cullman, AL
• Providers in Cullman, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.