Organization Active NPI

Troy Family Medicine, PC

  • Family Medicine Physician
  • Troy, AL
National Provider Identifier
1255481677
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00019306 Issued in AL
Legal business name
TROY FAMILY MEDICINE, PC
Practice address
101 Country Club Rd
Troy, AL 36079-3093
Phone
(334) 807-0235
Fax
(334) 807-0099
NPI assigned
Jan 10, 2007
Last updated
Jan 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Dr. Phylecya Yvette Cheatham, MDNPI 1952326704
Title
President
Phone
(334) 807-0235

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Family Medicine Physician 207Q00000X 00019306 AL Primary

Addresses

Primary practice location

101 Country Club Rd
Troy, AL 36079-3093

Mailing address

101 Country Club Rd
Troy, AL 36079-3093
Phone (334) 807-0235

Other identifiers 3

IdentifierTypeStateIssuer
000044674MedicaidAL
51044674OtherALBLUE CROSS PROVIDER #
01D0961776OtherALCLEA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100428000365 AL Part B Supplier - Clinic/Group Practice 2062549777 Receives reassigned benefits from 1 practitioner
Practice locations: Troy, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0961776Troy Family Medicine, PC101 Country Club Road, Troy, AL 36079Certificate of waiverJan 31, 2028

National Provider Directory

National Provider Directory

Locations

101 Country Club Rd
Troy, AL 36079
Phone (334) 807-0235

1320 Highway 231 S
Ste 4
Troy, AL 36081
Phone (334) 670-5475

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8826/brand/1/csg/1/fhir/r4

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": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1255481677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 COUNTRY CLUB RD",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360793093",
            "telephone_number": "334-807-0235",
            "fax_number": "334-807-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COUNTRY CLUB RD",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360793093",
            "telephone_number": "334-807-0235",
            "fax_number": "334-807-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROY FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "CHEATHAM",
        "authorized_official_first_name": "PHYLECYA",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-807-0235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00019306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000044674",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "51044674",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLEA",
            "identifier": "01D0961776",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.