NPIMap

Organization Active NPI

Whatley Health Services, Inc.

Doing business as Whatley Health Services at Aliceville

  • Federally Qualified Health Center (FQHC)
  • Aliceville, AL
National Provider Identifier
1295447787
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WHATLEY HEALTH SERVICES, INC.
Doing business as
Whatley Health Services at Aliceville
Practice address
432 5TH Street NW
Aliceville, AL 35442
Phone
(205) 758-6647
NPI assigned
Dec 16, 2022
Last updated
Jan 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
David Ellis Gay
Title
Ceo
Phone
(205) 349-3250

Specialties & licenses 1

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

Addresses

Primary practice location

432 5TH Street NW
Aliceville, AL 35442

Mailing address

2731 Martin Luther King Blvd
Tuscaloosa, AL 35401-5235
Phone (205) 758-6647

Other names 1

  • Whatley Health Services at Aliceville Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040206000846 AL Part B Supplier - Clinic/Group Practice 8224921705 Receives reassigned benefits from 230 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tuscaloosa, AL; Vernon, AL; Sipsey, AL; Livingston, AL; Greensboro, AL; Gordo, AL; Eutaw, AL; Carrollton, AL…
O20230315000408 AL Part A Provider - Federally Qualified Health Center (FQHC) 8224921705 Practice locations: Aliceville, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295447787. Details of each certification follow.

Federally qualified health center certification: CCN 011102

Legal name
WHATLEY HEALTH SERVICES INC
Doing business as
WHATLEY HEALTH SERVICES AT ALICEVILLE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 14, 2023
Last certification
Mar 14, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 11, 1997 in AL
Enrollment address
432 5TH St NW
Aliceville, AL 35442-2033

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 5

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
01D2277600Whatley Health Services at Aliceville432 5TH Street NW, Aliceville, AL 35442Certificate of waiverFeb 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Okaman Health Center16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Maxie Thomas Individual Corporate Director May 27, 1997
David Gay Individual Corporate DirectorChief Executive Officer Nov 1, 2018 100%
W-2 Managing EmployeeChief Executive Officer Nov 1, 2018 100%
Audrey J Ellis Individual Corporate Director Dec 1, 2007
James Morton Individual Corporate Director Jan 1, 2008
Reginald Zane Motley Individual Corporate Director May 24, 2022
Marvin Wiggins Individual Corporate Director Aug 24, 2021
Charlotte Carter Individual Corporate Director Mar 25, 1997
Kanita Sturdivant Individual Corporate Director Aug 24, 2001

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

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": "1671148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1295447787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 MARTIN LUTHER KING BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354015235",
            "telephone_number": "205-758-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 5TH STREET NW",
            "city": "ALICEVILLE",
            "state": "AL",
            "postal_code": "35442",
            "telephone_number": "205-758-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHATLEY HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-16",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ELLIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "205-349-3250"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whatley Health Services at Aliceville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aliceville, AL

Sources for this page

Verify at the official NPI Registry.