NPIMap

Organization Active NPI

Houston County Healthcare Authority

  • Family Medicine Physician
  • Dothan, AL
National Provider Identifier
1255876181
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HOUSTON COUNTY HEALTHCARE AUTHORITY
Practice address
4550 W Main St
Suite 1
Dothan, AL 36305-1130
Phone
(334) 446-4700
Fax
(334) 446-4720
NPI assigned
Jan 2, 2017
Organization subpart
Yes
Parent organization
HOUSTON COUNTY HEALTHCARE AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2017

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

Authorized official

Name
Mr. Robert Derek Miller
Title
Cfo
Phone
(334) 793-8111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4550 W Main St
Suite 1
Dothan, AL 36305-1130

Mailing address

PO Box 1928
Dothan, AL 36302-1928
Phone (334) 793-8087

Other identifiers 1

IdentifierTypeStateIssuer
153687MedicaidAL

Other names 1

  • Westway Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Houston County Hlthcare17 organizations share this tax ID, including this one
Part of
Houston County Hlthcare

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1483315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1255876181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1928",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363021928",
            "telephone_number": "334-793-8087",
            "fax_number": "334-678-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 W MAIN ST",
            "address_2": "SUITE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051130",
            "telephone_number": "334-446-4700",
            "fax_number": "334-446-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON COUNTY HEALTHCARE AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSTON COUNTY HEALTHCARE AUTHORITY",
        "enumeration_date": "2017-01-02",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DEREK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "334-793-8111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153687",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westway Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.