NPIMap

Organization Active NPI

Fairview Clinic, P.C.

  • Internal Medicine Physician
  • Dothan, AL
National Provider Identifier
1184693053
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FAIRVIEW CLINIC, P.C.
Practice address
1118 Ross Clark Cir
Suite 303
Dothan, AL 36301-3001
Phone
(334) 794-3192
Fax
(334) 792-7513
NPI assigned
Mar 14, 2006
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Ms. Debbie I Yurevich
Title
Administrator
Phone
(334) 794-3192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1118 Ross Clark Cir
Suite 303
Dothan, AL 36301-3001

Mailing address

1118 Ross Clark Cir
Suite 303
Dothan, AL 36301-3001
Phone (334) 794-3192

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051027001016 AL Part B Supplier - Clinic/Group Practice 5991722076 Receives reassigned benefits from 16 practitioners
Practice locations: Dothan, AL

National Provider Directory

National Provider Directory

Locations

1118 Ross Clark Cir
Ste 303
Dothan, AL 36301
Phone (334) 794-3192

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3134/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1184693053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 303",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-794-3192",
            "fax_number": "334-792-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 303",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-794-3192",
            "fax_number": "334-792-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "YUREVICH",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-794-3192",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.