Organization Active NPI

Pickens County Family Practice Center Inc

  • Family Medicine Physician
  • Gordo, AL
National Provider Identifier
1174675144
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8876 Issued in AL
Legal business name
PICKENS COUNTY FAMILY PRACTICE CENTER INC
Practice address
27340 Hwy 86
Gordo, AL 35466-7340
Phone
(205) 364-7135
NPI assigned
Jan 18, 2007
Last updated
Dec 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Authorized official

Name
Dr. John Brandon
Title
President
Phone
(205) 364-7135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8876 AL Primary

Addresses

Primary practice location

27340 Hwy 86
Gordo, AL 35466-7340

Mailing address

27340 Highway 86
Gordo, AL 35466

Other identifiers 1

IdentifierTypeStateIssuer
000015657MedicaidAL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2073262Pickens County Family Practice Center27340 Hwy 86, Gordo, AL 35466Provider-performed microscopyFeb 12, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1174675144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27340 HIGHWAY 86",
            "city": "GORDO",
            "state": "AL",
            "postal_code": "35466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27340 HWY 86",
            "city": "GORDO",
            "state": "AL",
            "postal_code": "354667340",
            "telephone_number": "205-364-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICKENS COUNTY FAMILY PRACTICE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-364-7135",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "8876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000015657",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gordo, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.