Organization Active NPI

Southcare Clinic, P.C.

  • Family Medicine Physician
  • Huntsville, AL
National Provider Identifier
1316034911
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18641 Issued in AL
Legal business name
SOUTHCARE CLINIC, P.C.
Practice address
11220 Memorial Pkwy SW
Suite Ab
Huntsville, AL 35803-4415
Phone
(256) 880-5818
Fax
(256) 883-5346
NPI assigned
Oct 6, 2006
Last updated
Jan 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Dr. Samuel J. Ribis, M.D.
Title
Owner
Phone
(256) 880-5818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 18641 AL Primary

Addresses

Primary practice location

11220 Memorial Pkwy SW
Suite Ab
Huntsville, AL 35803-4415

Mailing address

11220 Memorial Pkwy SW
Suite Ab
Huntsville, AL 35803-4415
Phone (256) 880-5818

Other identifiers 2

IdentifierTypeStateIssuer
98764OtherALBCBS
98764OtherALNAMCI

National Provider Directory

National Provider Directory

Locations

11220 S Memorial Pkwy
Ste Ab
Huntsville, AL 35803
Phone (256) 880-5818

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1316034911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11220 MEMORIAL PKWY SW",
            "address_2": "SUITE AB",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358034415",
            "telephone_number": "256-880-5818",
            "fax_number": "256-883-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 MEMORIAL PKWY SW",
            "address_2": "SUITE AB",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358034415",
            "telephone_number": "256-880-5818",
            "fax_number": "256-883-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCARE CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "RIBIS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-880-5818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "18641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "98764",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAMCI",
            "identifier": "98764",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.