NPIMap

Organization Active NPI

Health Care for Life Al, LLC

  • Optometrist
  • Russellville, AL
National Provider Identifier
1265794598
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HEALTH CARE FOR LIFE AL, LLC
Practice address
523 Gandy St NE
Ste a
Russellville, AL 35653-1961
Phone
(205) 208-9955
Fax
(256) 332-5403
NPI assigned
Jun 12, 2012
Last updated
Jun 10, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH CARE FOR LIFE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Authorized official

Name
Dr. Stuart M Greenberg, O.D.NPI 1780766824
Title
Partner/Managing Member
Phone
(256) 324-1918

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Podiatrist 213E00000X NU

Addresses

Primary practice location

523 Gandy St NE
Ste a
Russellville, AL 35653-1961

Mailing address

PO Box 335
Russellville, AL 35653-0335
Phone (205) 208-9955

Other identifiers 1

IdentifierTypeStateIssuer
142739MedicaidAL

National Provider Directory

National Provider Directory

Locations

15255 Highway 43
Ste 3
Russellville, AL 35653
Phone (256) 277-9440

Practitioners & affiliated clinicians

Practitioners 4

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": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1265794598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 335",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356530335",
            "telephone_number": "205-208-9955",
            "fax_number": "256-332-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 GANDY ST NE",
            "address_2": "STE A",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356531961",
            "telephone_number": "205-208-9955",
            "fax_number": "256-332-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE FOR LIFE AL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH CARE FOR LIFE, LLC",
        "enumeration_date": "2012-06-12",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "256-324-1918",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142739",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.