Russellville Internal Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

28146 Issued in AL

Legal business name

RUSSELLVILLE INTERNAL MEDICINE PC

Practice address

535 Gandy St NE
Russellville, AL 35653-1965

Phone

(256) 332-1120

Fax

(256) 332-1198

NPI assigned

Aug 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Miranda Decker, MDNPI 1699967612

Title

MD

Phone

(256) 332-1120

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miranda Decker, MD

  • Internal Medicine Physician
  • Russellville, AL
  • NPI 1699967612
  Medicare reassignment NPD Authorized official
• David Clarence Bish, DO

  • General Practice Physician
  • Eufaula, AL
  • NPI 1912093246
  NPD (past)

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1174715296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356530516",
            "telephone_number": "256-332-1120",
            "fax_number": "256-332-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 GANDY ST NE",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356531965",
            "telephone_number": "256-332-1120",
            "fax_number": "256-332-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELLVILLE INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "256-332-1120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "28146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russellville Hospital Inc.
• Russellville Hospital Inc.
• Russellville Hospital Inc.
• Russellville Hospital LLC
• Russellville Hospital, LLC
• Russellville Musculoskeletal Center Inc.
• Russellville Physician Practices LLC
• Russellville Physician Practices LLC
• Russellville Physician Practices LLC
• Russellville Physician Practices LLC

• Internal Medicine Physician in Russellville, AL
• Providers in Russellville, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.