Alabama Family Medical Center, LLC
Organization Active NPI Family Medicine Physician · Tuscaloosa, AL
NPI 1245226489 · NPPES record last updated Mar 11, 2025
Key facts
- NPI
- 1245226489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 21446 (AL)
- Legal business name
- ALABAMA FAMILY MEDICAL CENTER, LLC
- Practice address
- 1718 Veterans Memorial Pkwy
Suite C
Tuscaloosa, AL 35404 - Phone
- (205) 553-1900
- Fax
- (205) 553-4575
- NPI assigned
- Sep 22, 2005
- Organization subpart
- No
Authorized official
- Name
- Dr. Sasank Raheel Peramsetty, MD
- Title
- Medical Director
- Phone
- (205) 553-1900
Practitioners 19
-
Caitlyn Noel Barton, CRNP
-
Ijeoma Okeke, D.O
-
Tracy Christian Grissett, NURSE PRACTITIONER
-
John A Hartsell, PA
-
Jinwoo Hur, MD
-
Brenda Ferguson Sample, NP-C
-
Kelli E. Williams, CRNP
-
Sean Morris, NP
-
Shanna Lee Posey, CRNP
-
Amy Shirley, CRNP
-
Kristin Landham Johnson, PA-C
-
Mallory Brooke Nichols, FNP-C, CRNP
-
Bobbie C Sullivan, CRNP, FNP
-
Srilata Anne, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D0301823 | Alabama Family Medical Center LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250306001364 | AL | Part B Supplier - Clinic/Group Practice | 3173567260 |
Receives reassigned benefits from 18 practitioners Practice locations: Tuscaloosa, AL |
National Provider Directory
Locations
1718 Veterans Memorial Pkwy
Ste C
Tuscaloosa, AL 35404
Phone (205) 553-1900
1771 Skyland Blvd E
Tuscaloosa, AL 35405
Phone (205) 507-1119
1718 Vets Mem Pkwy
Ste A
Tuscaloosa, AL 35404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 24373 | AL | |
| Family Medicine Physician |
207Q00000X | 21446 | AL | Yes |
Addresses
Primary practice location
1718 Veterans Memorial Pkwy
Suite C
Tuscaloosa, AL 35404
Mailing address
1718 Veterans Memorial Pkwy
Suite C
Tuscaloosa, AL 35404-4708
Phone (205) 553-1900
Other providers in Tuscaloosa, AL
- Alabama CVS Pharmacy, L.L.C.
- Alabama Dental Professionals, PC
- Alabama Department of Mental Health
- Alabama Developmental Clinic, LLC
- Alabama Ear, Nose & Throat Specialists, LLC
- Alabama Family Podiatry
- Alabama Foot Center Incorporated
- Alabama Health Network
- Alabama Hearing Aid Center
- Alabama Heart Care LLC
All providers in Tuscaloosa, AL · Family Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.