NPIMap

Organization Active NPI

Wills Valley Family Medicine LLC

  • Family Medicine Physician
  • Collinsville, AL
National Provider Identifier
1316103237
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WILLS VALLEY FAMILY MEDICINE LLC
Practice address
13280 County Road 51
Collinsville, AL 35961-4174
Phone
(256) 524-3090
Fax
(256) 524-2885
NPI assigned
Jul 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Frances H Koe, MDNPI 1669566527
Title
Owner
Phone
(256) 524-3090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

13280 County Road 51
Collinsville, AL 35961-4174

Mailing address

13280 County Road 51
Collinsville, AL 35961-4174
Phone (256) 524-3090

Other identifiers 2

IdentifierTypeStateIssuer
1316103237MedicaidAL
510I080356OtherALMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080923000818 AL Part B Supplier - Clinic/Group Practice 9436226016 Receives reassigned benefits from 2 practitioners
Practice locations: Collinsville, AL

National Provider Directory

National Provider Directory

Locations

52 S Valley Ave
#B
Collinsville, AL 35961
Phone (256) 524-3090

52 S Valley Ave
Ste B
Collinsville, AL 35961
Phone (256) 524-3090

52 S Valley Ave
Collinsville, AL 35961
Phone (256) 524-3090

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13303/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1316103237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13280 COUNTY ROAD 51",
            "city": "COLLINSVILLE",
            "state": "AL",
            "postal_code": "359614174",
            "telephone_number": "256-524-3090",
            "fax_number": "256-524-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13280 COUNTY ROAD 51",
            "city": "COLLINSVILLE",
            "state": "AL",
            "postal_code": "359614174",
            "telephone_number": "256-524-3090",
            "fax_number": "256-524-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLS VALLEY FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "KOE",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-524-3090",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316103237",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "510I080356",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collinsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.