Southern Family Health

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

1029953 Issued in AL

Legal business name

SOUTHERN FAMILY HEALTH

Practice address

201 Old Highway 25 East
Columbiana, AL 35051

Phone

(205) 669-4884

NPI assigned

Jun 5, 2014

Last updated

Jun 5, 2014By 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

Mrs. Jackie Frederick, CRNPNPI 1235190885

Title

Owner

Phone

(205) 669-4884

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306259577. Details of each certification follow.

• CCN 013915 Rural health clinic · Active · Name & address match · Details

Rural health clinic certification: CCN 013915

Legal name

SOUTHERN FAMILY HEALTH, LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Aug 22, 2000

Last certification

Feb 20, 2025

Ownership / control type

1B

Facility address

201 Old Hwy 25 East
Columbiana, AL 35051

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

CLIA laboratory certificates

Practitioners 1

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.

• Jackie Frederick, CRNP

  • Family Nurse Practitioner
  • Columbiana, AL
  • NPI 1235190885
  Authorized official Same address or phone

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1306259577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OLD HIGHWAY 25 E",
            "city": "COLUMBIANA",
            "state": "AL",
            "postal_code": "350519373",
            "telephone_number": "205-669-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 OLD HIGHWAY 25 EAST",
            "city": "COLUMBIANA",
            "state": "AL",
            "postal_code": "35051",
            "telephone_number": "205-669-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-669-4884",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "AL",
            "license": "1029953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "541003915",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Siegfried, PHD
• Smart Dental Holdings, LLC (Luma Dentistry - Columbiana)
• Smart Dental Holdings, LLC (Luma Dentistry Columbiana)
• Southeast Shelby County Emergency Medical Rescue Inc
• Southern Family Health
• Stancil Handley O.D. PC
• State of Alabama
• David A Stull, DC
• Kayla Landefeld Tennyson, NP
• Robert Lee Thornburg, DMD

• Nursing Care Agency in Columbiana, AL
• Providers in Columbiana, AL by specialty
• Nursing Care Agency in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.