Gulf Family Medical LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GULF FAMILY MEDICAL LLC

Doing business as

Summerdale Medical Clinic

Practice address

511 State Highway 59 N
Summerdale, AL 36580-3686

Phone

(256) 550-1415

NPI assigned

Mar 29, 2022

Last updated

Oct 17, 2022By 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

Amanda Maddox, CRNPNPI 1073109708

Title

Business Owner

Phone

(251) 989-9400

Specialties & licenses 1

Addresses

Other names 1

• Summerdale Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Ethan Sterling Sellers, DO

  • Family Medicine Physician
  • Foley, AL
  • NPI 1871080986
  Medicare reassignment NPD
• Amanda Jean Maddox, FNP

  • Nurse Practitioner
  • Summerdale, AL
  • NPI 1073109708
  Authorized official Same address or phone
• Mary Ann Wooten, APRN

  • Family Nurse Practitioner
  • Summerdale, AL
  • NPI 1316531023
  NPD

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1285374470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 703",
            "city": "SUMMERDALE",
            "state": "AL",
            "postal_code": "365800703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 STATE HIGHWAY 59 N",
            "city": "SUMMERDALE",
            "state": "AL",
            "postal_code": "365803686",
            "telephone_number": "256-550-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF FAMILY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "251-989-9400",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summerdale Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Adams, BA PSY
• Melissa Martin Byrd, CPCP
• Coastal Pediatrics LLC
• Cindy Hatcher, MS, MFT-A, AADC
• Lifeguard Ambulance Service LLC (MedStar)
• Amanda Jean Maddox, FNP
• Alexandra Miller, CBS, RN
• Daniel Dale Perkins, MD

• Primary Care Clinic/Center in Summerdale, AL
• Providers in Summerdale, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.