NPIMap

Organization Active NPI

Community Hospital Inc

Doing business as Tallassee Internal Medicine

  • Internal Medicine Physician
  • Tallassee, AL
National Provider Identifier
1295040376
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMMUNITY HOSPITAL INC
Doing business as
Tallassee Internal Medicine
Practice address
80 Herren Hill Rd Ste a
Tallassee, AL 36078-1264
Phone
(334) 283-3844
Fax
(334) 283-3735
NPI assigned
Aug 12, 2010
Last updated
Jan 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Mr. Lee S Greer
Title
Cfo
Phone
(334) 283-3754

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X AL Primary

Addresses

Primary practice location

80 Herren Hill Rd Ste a
Tallassee, AL 36078-1264

Mailing address

805 Friendship Rd
Tallassee, AL 36078-1234
Phone (334) 283-3844

Other names 1

  • TALLASSEE INTERNAL MEDICINE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421001819 AL Part B Supplier - Clinic/Group Practice 2062408487 Receives reassigned benefits from 82 practitioners
6 other NPIs on this enrollment
Practice locations: Notasulga, AL; Tuskegee, AL; Tallassee, AL

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
01D2011958Tallassee Internal Medicine80 Herren Hill Rd Suite a, Tallassee, AL 36078Certificate of waiverAug 24, 2026

National Provider Directory

National Provider Directory
Tax ID family
William L Poole MD13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Home HealthTallassee, AL, CCN 017135 Home health agency 5% Or Greater Direct Ownership Interest (20%) Sep 20, 2019
Community Hospice CareTallassee, AL, CCN 011583 Hospice 5% Or Greater Direct Ownership Interest (75%)
Operational/Managerial Control (75%)		 Jul 1, 2023
Jul 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • C & P Home Health, LLC

    dba Community Home Health

    • Home Health Agency
    • Tallassee, AL
    • NPI 1952958019

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • C & P Hospice, LLC

    dba Community Hospice Care

    • Community Based Hospice Care Agency
    • Tallassee, AL
    • NPI 1487714218

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 84

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 84

NPI Registry JSON

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1295040376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 FRIENDSHIP RD",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360781234",
            "telephone_number": "334-283-3844",
            "fax_number": "334-283-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HERREN HILL RD STE A",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360781264",
            "telephone_number": "334-283-3844",
            "fax_number": "334-283-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "GREER",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "334-283-3754",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TALLASSEE INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tallassee, AL

Sources for this page

Verify at the official NPI Registry.