NPIMap

Organization Active NPI

Enterprise Urgent Care

Doing business as Ivy Creek Family Care of Enterprise

  • Urgent Care Clinic/Center
  • Enterprise, AL
National Provider Identifier
1285180729
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ENTERPRISE URGENT CARE
Doing business as
Ivy Creek Family Care of Enterprise
Practice address
6582 Boll Weevil Circle
Enterprise, AL 36330
Phone
(334) 347-2027
NPI assigned
Aug 25, 2016
Last updated
Feb 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
IVY CREEK HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Authorized official

Name
Michael D Bruce
Title
Ceo
Phone
(334) 567-4311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X AL Primary

Addresses

Primary practice location

6582 Boll Weevil Circle
Enterprise, AL 36330

Mailing address

6582 Boll Weevil Circle
Enterprise, AL 36330
Phone (334) 347-2027

Other names 1

  • IVY CREEK FAMILY CARE OF ENTERPRISE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160907001338 AL Part B Supplier - Clinic/Group Practice 1456647197 Receives reassigned benefits from 150 practitioners
Practice locations: Enterprise, 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
01D2115971Ivy Creek Urgent Care Enterprise6582 Boll Weevil Circle, Enterprise, AL 36330Certificate of waiverDec 31, 2026

National Provider Directory

National Provider Directory

Locations

6582 Boll Weevil Cir
Enterprise, AL 36330
Phone (334) 347-2027

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 150

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.

View all 150

NPI Registry JSON

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1285180729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6582 BOLL WEEVIL CIRCLE",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "36330",
            "telephone_number": "334-347-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6582 BOLL WEEVIL CIRCLE",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "36330",
            "telephone_number": "334-347-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENTERPRISE URGENT CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IVY CREEK HEALTHCARE LLC",
        "enumeration_date": "2016-08-25",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-567-4311"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IVY CREEK FAMILY CARE OF ENTERPRISE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.