NPIMap

Organization Active NPI

First Care Medical Clinic

  • Internal Medicine Physician
  • Gadsden, AL
National Provider Identifier
1184688681
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20405 Issued in AL
Legal business name
FIRST CARE MEDICAL CLINIC
Practice address
311 South 4TH Street
Gadsden, AL 35901-5212
Phone
(256) 543-9955
Fax
(256) 543-9351
NPI assigned
Apr 13, 2006
Last updated
Oct 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Authorized official

Name
Oluwole S. Akisanya, M.D.NPI 1467416941
Title
Owner/Physician
Phone
(256) 543-9955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20405 AL Primary

Addresses

Primary practice location

311 South 4TH Street
Gadsden, AL 35901-5212

Mailing address

311 South 4TH Street
Gadsden, AL 35901-5212
Phone (256) 543-9955

Other identifiers 1

IdentifierTypeStateIssuer
000060841MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080715000455 AL Part B Supplier - Clinic/Group Practice 8123191715 Receives reassigned benefits from 6 practitioners
Practice locations: Gadsden, AL

National Provider Directory

National Provider Directory

Locations

309 S 4th St
Gadsden, AL 35901
Phone (256) 543-9955

Practitioners & affiliated clinicians

Practitioners 9

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": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1184688681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 SOUTH 4TH STREET",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015212",
            "telephone_number": "256-543-9955",
            "fax_number": "256-543-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 SOUTH 4TH STREET",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015212",
            "telephone_number": "256-543-9955",
            "fax_number": "256-543-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CARE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "AKISANYA",
        "authorized_official_first_name": "OLUWOLE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "256-543-9955",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "20405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000060841",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.