NPIMap

Organization Active NPI

Franklin Primary Health Center, Inc

Doing business as Maysville Medical Center

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
National Provider Identifier
1225006679
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FRANKLIN PRIMARY HEALTH CENTER, INC
Doing business as
Maysville Medical Center
Practice address
1956 Duval St
Mobile, AL 36606
Phone
(251) 471-3747
Fax
(251) 450-1445
NPI assigned
Mar 10, 2006
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANKLIN PRIMARY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Mr. Charles White
Title
Chief Executive Officer
Phone
(251) 432-4117

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

1956 Duval St
Mobile, AL 36606

Mailing address

PO Box 2048
Mobile, AL 36652-2048
Phone (251) 432-4117

Other identifiers 2

IdentifierTypeStateIssuer
630003014MedicaidAL
Q727OtherALBC/BS

Other names 1

  • Maysville Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040618000827 AL Part B Supplier - Clinic/Group Practice 1658356308 Receives reassigned benefits from 126 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mobile, AL; Prichard, AL; Uriah, AL; Frisco City, AL; Loxley, AL; Brewton, AL; Evergreen, AL; Foley, AL…
O20061211000100 AL Part A Provider - Federally Qualified Health Center (FQHC) 1658356308 Practice locations: Mobile, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225006679. Details of each certification follow.

Federally qualified health center certification: CCN 011841

Legal name
FRANKLIN PRIMARY HEALTH CENTER, INC.
Doing business as
MAYSVILLE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 17, 1992
Last certification
Aug 17, 1992
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jan 31, 1975 in AL
Enrollment address
1956 Duval St
Mobile, AL 36606-1145

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 25

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 25

National Provider Directory

National Provider Directory
Tax ID family
Frnaklin Primary Health25 organizations share this tax ID, including this one
Part of
Frnaklin Primary Health

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Myrtis Jones Individual Corporate OfficerBoard Member Jan 1, 2016
Myriam Brister Individual Corporate OfficerBoard Member Jan 1, 2016
Chris McGadney Individual Corporate OfficerBoard Member Jan 1, 2016
Ronald Martin Individual Corporate OfficerBoard Member Jan 1, 2016
Herman Harville Individual Corporate OfficerBoard Member Jan 1, 2016
Rosa Hart Individual Corporate OfficerBoard Member Jan 1, 2016
Stan Chavis Individual Corporate OfficerBoard Member Jan 1, 2016
Lula Ifill Individual Corporate OfficerBoard Member Jan 1, 2016
Sydney Raine Individual Corporate OfficerBoard Member Jan 1, 2016
Charles White Individual Corporate OfficerCeo Jan 1, 2016
Corporate Director Jan 1, 2016
W-2 Managing EmployeeCeo Jan 1, 2016

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Foley School Based Health CenterFoley, AL, CCN 011028 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1225006679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2048",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366522048",
            "telephone_number": "251-432-4117",
            "fax_number": "251-436-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1956 DUVAL ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36606",
            "telephone_number": "251-471-3747",
            "fax_number": "251-450-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN PRIMARY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANKLIN PRIMARY HEALTH CENTER, INC.",
        "enumeration_date": "2006-03-10",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "251-432-4117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630003014",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Q727",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maysville Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maysville Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.