Active NPI
Pickens County Family Practice Center Inc
- Family Medicine Physician
- Gordo, AL
National Provider Identifier
1174675144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 8876
- 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, 2007
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000015657 | Medicaid | AL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2073262 | Pickens County Family Practice Center | Provider-performed microscopy | Feb 12, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Anesthesiology Physician
- Birmingham, AL
- NPI 1457492340
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
- Mills Pills LLC - Gordo (Mills Discount Pharmacy)
- Jennifer Montgomery
- Brooke Owens
- Erika Ammons Payne, LAT, ATC
- Rex Beach Perkins Jr., M.D.
- Pickens County Health Care Authority (Gordo Primary Care Clinic)
- Pickens County Medical Center (Paul D Lavender)
- Pickens County Primary Care, P.C
- Pickens County Primary Care, PC
- Ellynn Joann Rolett, LAT, ATC
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.