NPIMap

Organization Active NPI

Physicians Care of Clarke

  • Federally Qualified Health Center (FQHC)
  • Sweet Water, AL
National Provider Identifier
1295402667
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PHYSICIANS CARE OF CLARKE
Practice address
31431 Ala Highway 10
Sweet Water, AL 36782-4936
Phone
(334) 994-6300
NPI assigned
Aug 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Authorized official

Name
Farrell A Turner
Title
Ceo
Phone
(256) 201-0095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

31431 Ala Highway 10
Sweet Water, AL 36782-4936

Mailing address

24B Camden Byp
Camden, AL 36726-1770
Phone (334) 882-1919

Other names 1

  • AKA PHYSICIANS CARE OF SWEET WATER Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210921001942 AL Part B Supplier - Clinic/Group Practice 2961809736 Receives reassigned benefits from 10 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sweet Water, AL; Thomasville, AL; Grove Hill, AL; Fulton, AL; Camden, AL; Butler, AL
O20220113000676 AL Part A Provider - Federally Qualified Health Center (FQHC) 2961809736 Practice locations: Sweet Water, AL

Federally qualified health center certification: CCN 011093

Legal name
PHYSICIANS CARE OF CLARKE
Doing business as
PHYSICIANS CARE OF SWEET WATER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 27, 2021
Last certification
Oct 27, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 20, 2018 in AL
Enrollment address
31431 Al Highway 10
Sweet Water, AL 36782-4941

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.

National Provider Directory

National Provider Directory
Tax ID family
Aka Fulton Family Medical5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael Paul Norris Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Doris L Morris Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
John Riggs Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Ricky L Powell Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
William Robertson Phillippi Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Farrell a. Turner Individual Corporate OfficerCeo Apr 20, 2020
W-2 Managing EmployeeCeo Apr 20, 2020
Operational/Managerial ControlCeo Apr 20, 2020
Dwight Dwayne Figgers Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Larry Colston Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Sherril B Glass Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Steven Brent Megginson Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1295402667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24B CAMDEN BYP",
            "city": "CAMDEN",
            "state": "AL",
            "postal_code": "367261770",
            "telephone_number": "334-882-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31431 ALA HIGHWAY 10",
            "city": "SWEET WATER",
            "state": "AL",
            "postal_code": "367824936",
            "telephone_number": "334-994-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CARE OF CLARKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "FARRELL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-201-0095"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AKA PHYSICIANS CARE OF SWEET WATER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sweet Water, AL

Sources for this page

Verify at the official NPI Registry.