Cahaba Medical Care Foundation

Organization Active NPI Federally Qualified Health Center (FQHC) · Centreville, AL

NPI 1316201809 · NPPES record last updated Jun 5, 2017

Key facts

NPI
1316201809
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
CAHABA MEDICAL CARE FOUNDATION
Practice address
195 Hospital Dr
Centreville, AL 35042-2935
Phone
(205) 926-2992
Fax
(205) 926-2993
NPI assigned
Jun 28, 2012
Organization subpart
No

Authorized official

Name
Dr. John Bryan Waits, M.D.
Title
Ceo
Phone
(205) 926-2992

Owners & managing parties with NPI records 6

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 240

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

View all 240

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2120312Cahaba Medical Care - West End
1308 Tuscaloosa Ave SW, Birmingham, AL 35211
Provider-performed microscopyOct 12, 2026
01D2137183Cahaba Medical Care - Ensley
1925 Avenue E, Birmingham, AL 35218
Provider-performed microscopySep 20, 2027
01D2152293Cahaba Medical Care- Brent Elementary School
160 4TH St, Brent, AL 35034
Certificate of waiverAug 6, 2026
01D2180099Cahaba Medical Care - Bessemer
975 9TH Ave SW, Suite 310, Bessemer, AL 35022
Provider-performed microscopyMar 5, 2028
01D2300600Cahaba Medical Care-Fairfield High Preparatory SCH
610 Valley, Fairfield, AL 35064
Certificate of waiverMar 12, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled (27 enrollments) in AL

Federally qualified health center certification: CCN 011807

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
CAHABA MEDICAL CARE
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
195 Hospital Dr
Centreville, AL 35042-2935

Federally qualified health center certification: CCN 011021

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
WOODSTOCK FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 15, 2015
Last certification
Apr 15, 2015
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
28921 Highway 5
Woodstock, AL 35188-3613

Federally qualified health center certification: CCN 011024

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
CAHABA MEDICAL CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 13, 2015
Last certification
Nov 13, 2015
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
9431 Al Highway 22
Maplesville, AL 36750-3264

Federally qualified health center certification: CCN 011029

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
CAHABA MEDICAL CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 1, 2017
Last certification
Feb 1, 2017
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
975 9TH Ave SW
Ste 310
Bessemer, AL 35022-7839

Federally qualified health center certification: CCN 011030

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
CAHABA MEDICAL CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 2, 2017
Last certification
Feb 2, 2017
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
1308 Tuscaloosa Ave SW
Birmingham, AL 35211-1948

Federally qualified health center certification: CCN 011034

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
CAHABA MEDICAL CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 23, 2017
Last certification
May 23, 2017
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
1925 Avenue E
Ensley, AL 35218-1619

Federally qualified health center certification: CCN 011040

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
CAHABA MEDICAL CARE FOUNDATION-WBES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 25, 2018
Last certification
Jun 25, 2018
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
828 Cahaba River Dr
West Blocton, AL 35184-3932

Federally qualified health center certification: CCN 011033

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
CAHABA MEDICAL CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 10, 2018
Last certification
Jul 10, 2018
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
160 4TH St
Brent, AL 35034-3739

Federally qualified health center certification: CCN 011044

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 31, 2018
Last certification
Aug 31, 2018
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
1303 Washington St
Marion, AL 36756-3217

Federally qualified health center certification: CCN 011054

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 2, 2019
Last certification
Apr 2, 2019
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
623 8TH Ave W
Birmingham, AL 35204-3604

Federally qualified health center certification: CCN 011055

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
CAHABA MEDICAL CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 5, 2019
Last certification
Apr 5, 2019
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
260 Walnut St
Centreville, AL 35042-2332

Federally qualified health center certification: CCN 011063

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 18, 2019
Last certification
Oct 18, 2019
Ownership / control type
For profit – individual
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
1301 Highland Dr
Fairfield, AL 35064-1643

Federally qualified health center certification: CCN 011061

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 21, 2019
Last certification
Oct 21, 2019
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
715 Valley Rd
Fairfield, AL 35064-2666

Federally qualified health center certification: CCN 011065

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 22, 2019
Last certification
Oct 22, 2019
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
301 61St St
Fairfield, AL 35064-1957

Federally qualified health center certification: CCN 011062

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 22, 2019
Last certification
Oct 22, 2019
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
7000 Grasselli Rd
Fairfield, AL 35064-2424

Federally qualified health center certification: CCN 011064

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 22, 2019
Last certification
Oct 22, 2019
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
714 12TH St SW
Birmingham, AL 35211-1982

Federally qualified health center certification: CCN 011079

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 3, 2020
Last certification
Aug 3, 2020
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
900 Arkadelphia Rd
RM 240
Birmingham, AL 35254-0001

Federally qualified health center certification: CCN 011082

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 16, 2021
Last certification
Mar 16, 2021
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
319 Magnolia St
West Blocton, AL 35184-2378

Federally qualified health center certification: CCN 011090

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 3, 2021
Last certification
Sep 3, 2021
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
1984 Main St
Brent, AL 35034-3503

Federally qualified health center certification: CCN 011089

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 20, 2021
Last certification
Oct 20, 2021
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
801 Princeton Ave SW
Ste 505
Birmingham, AL 35211-1308

Federally qualified health center certification: CCN 011097

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 14, 2022
Last certification
Apr 14, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
321 Whiskey Run Rd
Camden, AL 36726-2303

Federally qualified health center certification: CCN 011098

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 11, 2022
Last certification
Jul 11, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
200 Oslo Cir
Birmingham, AL 35211-5937

Federally qualified health center certification: CCN 011100

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 21, 2022
Last certification
Sep 21, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
1010 1St St N
Ste 350
Alabaster, AL 35007-8619

Federally qualified health center certification: CCN 011004

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 21, 2022
Last certification
Nov 21, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
4614 Carnegie Ave
Fairfield, AL 35064-1430

Federally qualified health center certification: CCN 011110

Legal name
CAHABA MEDICAL CARE FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 12, 2023
Last certification
May 12, 2023
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
873 Dennison Ave SW
Ste 102
Birmingham, AL 35211-3867

Federally qualified health center certification: CCN 011114

Legal name
CAHABA MEDICAL CARE FOUNDATION
Doing business as
CAHABA MEDICAL CARE - FAIRFIELD HIGH PREPARATORY SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 11, 2023
Last certification
Dec 11, 2023
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Oct 5, 2010 in AL
Enrollment address
610 Valley Rd
Fairfield, AL 35064-2232

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Ashlie Blake Cash
Individual
Corporate Officer Feb 28, 2017
Corporate Officer
Board Chair
Feb 28, 2017
Corporate Officer
Chair
Feb 28, 2017
Corporate Officer
Member
Feb 28, 2017
Scott W Kemp
Individual
Corporate Officer Feb 28, 2017
Corporate Officer
Board Member
Feb 28, 2017
Corporate Officer
Member
Feb 28, 2017
Corporate Officer
Qi Committee
Feb 28, 2017
Corporate Officer
Member
Feb 28, 2019
Olivia Raulerson
Individual
Corporate Officer Jan 28, 2020
Corporate Officer
Board Member
Jan 28, 2020
Corporate Officer
Member
Jan 28, 2020
Corporate Officer Jan 1, 2020
Kay Cox
Individual
Corporate Officer Jul 22, 2013
W-2 Managing Employee Jul 22, 2013
Corporate Officer
Coo
Jul 22, 2013
W-2 Managing Employee
Coo
Jul 22, 2013
Corporate Officer
Cco
Jul 22, 2013
W-2 Managing Employee
Cco
Jul 22, 2013
W-2 Managing Employee
Coo
Jul 22, 2019
W-2 Managing Employee Jul 22, 2021
W-2 Managing Employee Jul 22, 2022
John Marchant
Individual
Corporate Officer Feb 28, 2017
Corporate Officer Aug 28, 2017
Corporate Officer
Board Member
Feb 28, 2017
Corporate Officer
Member
Feb 28, 2017
Erika Crum
Individual
Corporate Officer Jan 22, 2019
Corporate Officer
Board Member
Jan 22, 2019
Corporate Officer
Member
Jan 22, 2019
John B Waits
Individual
Corporate Officer Jul 1, 2012
W-2 Managing Employee Jul 1, 2012
Corporate Officer
Ceo
Oct 5, 2010
Corporate Officer Oct 1, 2012
W-2 Managing Employee Oct 1, 2012
Corporate Officer
Ceo
Oct 1, 2012
Corporate Officer
Ceo
Jan 1, 2012
W-2 Managing Employee
Ceo
Oct 1, 2012
W-2 Managing Employee
MD;
Oct 1, 2012
Corporate Director Oct 1, 2012
W-2 Managing Employee Oct 1, 2023
Lacy M Smith
Individual
Corporate Officer Jul 1, 2012
W-2 Managing Employee Jul 1, 2012
Corporate Officer
Cmo
Oct 5, 2010
Corporate Officer
Cmo
Oct 1, 2013
W-2 Managing Employee Oct 1, 2012
Corporate Officer
Cmo
Oct 1, 2012
Corporate Officer Oct 1, 2012
W-2 Managing Employee
Cmo
Oct 1, 2012
Corporate Officer Oct 1, 2011
Glenda Carter
Individual
Corporate Officer Jul 24, 2018
Corporate Officer
Board Member
Jul 24, 2018
Corporate Officer
Member
Jul 24, 2018
Wanda Larosiliere
Individual
Corporate Officer Jan 23, 2018
Corporate Officer
Board Member
Jan 23, 2018
Corporate Officer
Member
Jan 23, 2018
Willie Dunn
Individual
Corporate Officer Aug 28, 2018
Corporate Officer
Board Member
Aug 28, 2018
Corporate Officer
Member
Aug 28, 2018
Corporate Officer
Vice Chair
Aug 28, 2018
Hollie B Tillery
Individual
Corporate Officer Jul 26, 2016
Corporate Director Jul 26, 2016
Corporate Officer
Board Secretary
Jul 26, 2016
Corporate Officer
Secretary
Jul 26, 2016
Corporate Officer Jan 28, 2020
Cahaba Medical Care Foundation
Organization · Centreville, AL
Non-profit
Operational/Managerial Control Oct 5, 2010 100%
5% Or Greater Direct Ownership Interest Oct 1, 2023
5% Or Greater Direct Ownership Interest Oct 1, 2012 100%
Operational/Managerial Control Dec 11, 2016
5% Or Greater Direct Ownership Interest Oct 1, 2012
5% Or Greater Direct Ownership Interest Oct 1, 2023 100%
Ann Sheppard
Individual
Corporate Officer Jan 26, 2021
Corporate Officer
Board Member
Jan 26, 2021
Corporate Officer
Member
Jan 26, 2021
Corporate Officer Jan 1, 2021
Bevin Tomlin
Individual
Corporate Officer Jan 27, 2016
James M Oakley
Individual
Corporate Officer
Board Member
Oct 23, 2023
Corporate Officer Oct 23, 2023
Corporate Officer
Member
Oct 23, 2023
Corporate Director Oct 23, 2023
Hal Harrison
Individual
Corporate Officer
Member
Jun 25, 2024
Corporate Director Jun 25, 2024
Corporate Officer Jun 25, 2024
Darlene Holifield
Individual
Corporate Officer Apr 24, 2014
Pricilla Mack
Individual
Corporate Officer Jul 26, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120814000537 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Centreville, AL
O20121120000238 AL Part B Supplier - Clinic/Group Practice 1355597923 Receives reassigned benefits from 220 practitioners
1 other NPI on this enrollment
Practice locations: Birmingham, AL; Tuscaloosa, AL; Northport, AL; Centreville, AL; Bessemer, AL
O20150413001444 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Woodstock, AL
O20151113002031 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Maplesville, AL
O20170201001483 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Bessemer, AL
O20170202002202 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Birmingham, AL
O20170523002098 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Ensley, AL
O20180625001571 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: West Blocton, AL
O20180626000967 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Brent, AL
O20180804000052 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Marion, AL
O20190402002891 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Birmingham, AL
O20190405001803 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Centreville, AL
O20191018001611 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Fairfield, AL
O20191021002028 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Fairfield, AL
O20191022000377 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Fairfield, AL
O20191022000833 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Fairfield, AL
O20191022001213 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Birmingham, AL
O20200803000701 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Birmingham, AL
O20210408000187 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: West Blocton, AL
O20210910000875 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Brent, AL
O20211025000808 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Birmingham, AL
O20220419000844 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Camden, AL
O20220727000618 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Birmingham, AL
O20221024002855 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Alabaster, AL
O20230127002805 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Fairfield, AL
O20230614000476 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Birmingham, AL
O20231213004106 AL Part a Provider - Federally Qualified Health Center (FQHC) 1355597923 Practice locations: Fairfield, AL

National Provider Directory

Locations

975 9th Ave SW
Ste 310
Bessemer, AL 35022
Phone (205) 277-2358

200 Oslo Cir
Birmingham, AL 35211
Phone (205) 944-3944

160 4th St
Brent, AL 35034
Phone (205) 928-6045

195 Hospital Dr
Centreville, AL 35042
Phone (205) 225-7455

1301 Highland Dr
Fairfield, AL 35064

7000 Grasselli Rd
Fairfield, AL 35064
Phone (205) 791-5048

715 Valley Rd
Fairfield, AL 35064
Phone (205) 791-5048

1303 Washington St
Marion, AL 36756
Phone (334) 247-1006

319 Magnolia St
West Blocton, AL 35184
Phone (205) 928-3365

828 Cahaba River Dr
West Blocton, AL 35184

Specialties & licenses

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

Addresses

Primary practice location

195 Hospital Dr
Centreville, AL 35042-2935

Mailing address

195 Hospital Dr
Centreville, AL 35042-2935
Phone (205) 926-2992

Other identifiers

IdentifierTypeStateIssuer
01-1029OtherALMEDICARE PTAN
01-1030OtherALMEDICARE PTAN

Other providers in Centreville, AL

All providers in Centreville, AL · Federally Qualified Health Center (FQHC) in Alabama

Sources for this page

Verify at the official NPI Registry.