Millport Fam Practice Clinic, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MILLPORT FAM PRACTICE CLINIC, LLC

Practice address

13530 Highway 96
Millport, AL 35576-2522

Phone

(205) 662-5784

Fax

(205) 662-5786

NPI assigned

Mar 5, 2007

Last updated

May 28, 2015By 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

Dr. Robert E Swanson, DNP, CRNPNPI 1508851486

Title

Managing Partner

Phone

(205) 662-5784

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Robert Enoch Swanson, CRNP

  • Family Nurse Practitioner
  • Millport, AL
  • NPI 1508851486
  NPD (past) Authorized official

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1265561328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13530 HIGHWAY 96",
            "city": "MILLPORT",
            "state": "AL",
            "postal_code": "355762522",
            "telephone_number": "205-662-5784",
            "fax_number": "205-662-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13530 HIGHWAY 96",
            "city": "MILLPORT",
            "state": "AL",
            "postal_code": "355762522",
            "telephone_number": "205-662-5784",
            "fax_number": "205-662-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLPORT FAM PRACTICE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "205-662-5784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, CRNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "541003936",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fayette Pharmacy Inc (Joe Golden Drug)
• FMC Medical Clinic Millport
• Lamar Primary Care LLC
• Hannah L Livingston, CRNP
• Lulu and Laura Foundation
• Millport Family Practice Clinic, LLC
• Millport Holdings DME LLC
• Millport Internal Medicine
• Pollard Spine and Spa LLC
• Dalton Pollard, DC

• Clinic/Center in Millport, AL
• Providers in Millport, AL by specialty
• Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.