Self-Recovery, LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

00022660 Issued in AL

Legal business name

SELF-RECOVERY, LLC

Practice address

106 N Lanier Ave
Lanett, AL 36863-2014

Phone

(334) 644-6848

Fax

(334) 644-5443

NPI assigned

Dec 4, 2006

Last updated

Dec 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tommy Moore, CEO

Title

Owner

Phone

(334) 644-6848

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 13

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.

• Louis Divalentin, M.D.

  • Internal Medicine Physician
  • Anniston, AL
  • NPI 1982625869
  Medicare reassignment Care Compare group NPD
• Salahuddin Farooqui, MD

  • Internal Medicine Physician
  • Eutaw, AL
  • NPI 1447353982
  Medicare reassignment Care Compare group
• Carl S Blankenship, MD

  • Anesthesiology Physician
  • Fort Payne, AL
  • NPI 1912922428
  Medicare reassignment NPD
• Almena Free, M.D.

  • Internal Medicine Physician
  • Anniston, AL
  • NPI 1144244070
  Medicare reassignment NPD
• William Barton Perry, M.D.

  • Family Medicine Physician
  • Centre, AL
  • NPI 1538184635
  Medicare reassignment NPD
• Carla N Thomas, M.D.

  • Family Medicine Physician
  • Anniston, AL
  • NPI 1194786830
  Medicare reassignment NPD
• Charles S Tompkins, M.D.

  • Family Medicine Physician
  • Luverne, AL
  • NPI 1760418438
  Medicare reassignment NPD
• Judy Cooke Travis, MD

  • Family Medicine Physician
  • Demopolis, AL
  • NPI 1518051788
  Medicare reassignment NPD
• Michael Nolan Gordon, MD

  • Internal Medicine Physician
  • York, AL
  • NPI 1235240516
  Medicare reassignment
• Tahir Siddiq, M.D.

  • Specialist
  • Union Springs, AL
  • NPI 1174631758
  Medicare reassignment
• John C Simmons, MD

  • General Practice Physician
  • Linden, AL
  • NPI 1104832724
  NPD (past)
• Russell Dean Ulrich, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Piedmont, AL
  • NPI 1407850126
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1255409447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N LANIER AVE",
            "city": "LANETT",
            "state": "AL",
            "postal_code": "368632014",
            "telephone_number": "334-644-6848",
            "fax_number": "334-644-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N LANIER AVE",
            "city": "LANETT",
            "state": "AL",
            "postal_code": "368632014",
            "telephone_number": "334-644-6848",
            "fax_number": "334-644-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF-RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-644-6848",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AL",
            "license": "00022660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lees Personal Assisted Living LLC (Lees Personal assisted Living)
• Rowdy Matt Meadows, PHARMACIST
• Laura Paige Niblett, M.S., CCC-SLP
• Oasis Psychiatric Services, LLC
• Margaret Robb, RPH
• Selfrecovery
• Smile Design Center LLC
• Sheilah Sermana Soriano, PT
• The Kroger Co (Kroger Pharmacy)
• Hannah Miller Tremlett, M.S., CCC-SLP

• General Acute Care Hospital in Lanett, AL
• Providers in Lanett, AL by specialty
• General Acute Care Hospital in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.