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
-
Scott W Kemp, D.O.
-
John Bryan Waits, M.D.
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 2
Member of 1
Practitioners 240
-
Kathryn Claire Ahalt, FNP-C
-
Kelsey Ankenbrandt, CRNP
-
Anna Laine Anthony, FNP-C
-
Rowell S Ashford II, M.D.
-
Deborah Austin, CRNP
-
Amanda Barton, CRNP
-
Sumpter Dudley Blackmon, M.D.
-
Josue C Breaux, MD
-
Alice Springer Bristow, CRNP
-
Keisha Brown, OD
-
Jasmine Bush, CRNP
-
Chasity Clark, PA
-
Yocunda Clayton, M.D.
-
Catrina Corbell, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2120312 | Cahaba Medical Care - West End | Provider-performed microscopy | Oct 12, 2026 |
| 01D2137183 | Cahaba Medical Care - Ensley | Provider-performed microscopy | Sep 20, 2027 |
| 01D2152293 | Cahaba Medical Care- Brent Elementary School | Certificate of waiver | Aug 6, 2026 |
| 01D2180099 | Cahaba Medical Care - Bessemer | Provider-performed microscopy | Mar 5, 2028 |
| 01D2300600 | Cahaba Medical Care-Fairfield High Preparatory SCH | Certificate of waiver | Mar 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
| Name | Role | Since | Share |
|---|---|---|---|
| Ashlie Blake Cash |
Corporate Officer | Feb 28, 2017 | |
| Corporate Officer |
Feb 28, 2017 | ||
| Corporate Officer |
Feb 28, 2017 | ||
| Corporate Officer |
Feb 28, 2017 | ||
| Scott W Kemp |
Corporate Officer | Feb 28, 2017 | |
| Corporate Officer |
Feb 28, 2017 | ||
| Corporate Officer |
Feb 28, 2017 | ||
| Corporate Officer |
Feb 28, 2017 | ||
| Corporate Officer |
Feb 28, 2019 | ||
| Olivia Raulerson |
Corporate Officer | Jan 28, 2020 | |
| Corporate Officer |
Jan 28, 2020 | ||
| Corporate Officer |
Jan 28, 2020 | ||
| Corporate Officer | Jan 1, 2020 | ||
| Kay Cox |
Corporate Officer | Jul 22, 2013 | |
| W-2 Managing Employee | Jul 22, 2013 | ||
| Corporate Officer |
Jul 22, 2013 | ||
| W-2 Managing Employee |
Jul 22, 2013 | ||
| Corporate Officer |
Jul 22, 2013 | ||
| W-2 Managing Employee |
Jul 22, 2013 | ||
| W-2 Managing Employee |
Jul 22, 2019 | ||
| W-2 Managing Employee | Jul 22, 2021 | ||
| W-2 Managing Employee | Jul 22, 2022 | ||
| John Marchant |
Corporate Officer | Feb 28, 2017 | |
| Corporate Officer | Aug 28, 2017 | ||
| Corporate Officer |
Feb 28, 2017 | ||
| Corporate Officer |
Feb 28, 2017 | ||
| Erika Crum |
Corporate Officer | Jan 22, 2019 | |
| Corporate Officer |
Jan 22, 2019 | ||
| Corporate Officer |
Jan 22, 2019 | ||
| John B Waits |
Corporate Officer | Jul 1, 2012 | |
| W-2 Managing Employee | Jul 1, 2012 | ||
| Corporate Officer |
Oct 5, 2010 | ||
| Corporate Officer | Oct 1, 2012 | ||
| W-2 Managing Employee | Oct 1, 2012 | ||
| Corporate Officer |
Oct 1, 2012 | ||
| Corporate Officer |
Jan 1, 2012 | ||
| W-2 Managing Employee |
Oct 1, 2012 | ||
| W-2 Managing Employee |
Oct 1, 2012 | ||
| Corporate Director | Oct 1, 2012 | ||
| W-2 Managing Employee | Oct 1, 2023 | ||
| Lacy M Smith |
Corporate Officer | Jul 1, 2012 | |
| W-2 Managing Employee | Jul 1, 2012 | ||
| Corporate Officer |
Oct 5, 2010 | ||
| Corporate Officer |
Oct 1, 2013 | ||
| W-2 Managing Employee | Oct 1, 2012 | ||
| Corporate Officer |
Oct 1, 2012 | ||
| Corporate Officer | Oct 1, 2012 | ||
| W-2 Managing Employee |
Oct 1, 2012 | ||
| Corporate Officer | Oct 1, 2011 | ||
| Glenda Carter |
Corporate Officer | Jul 24, 2018 | |
| Corporate Officer |
Jul 24, 2018 | ||
| Corporate Officer |
Jul 24, 2018 | ||
| Wanda Larosiliere |
Corporate Officer | Jan 23, 2018 | |
| Corporate Officer |
Jan 23, 2018 | ||
| Corporate Officer |
Jan 23, 2018 | ||
| Willie Dunn |
Corporate Officer | Aug 28, 2018 | |
| Corporate Officer |
Aug 28, 2018 | ||
| Corporate Officer |
Aug 28, 2018 | ||
| Corporate Officer |
Aug 28, 2018 | ||
| Hollie B Tillery |
Corporate Officer | Jul 26, 2016 | |
| Corporate Director | Jul 26, 2016 | ||
| Corporate Officer |
Jul 26, 2016 | ||
| Corporate Officer |
Jul 26, 2016 | ||
| Corporate Officer | Jan 28, 2020 | ||
| Cahaba Medical Care Foundation |
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 |
Corporate Officer | Jan 26, 2021 | |
| Corporate Officer |
Jan 26, 2021 | ||
| Corporate Officer |
Jan 26, 2021 | ||
| Corporate Officer | Jan 1, 2021 | ||
| Bevin Tomlin |
Corporate Officer | Jan 27, 2016 | |
| James M Oakley |
Corporate Officer |
Oct 23, 2023 | |
| Corporate Officer | Oct 23, 2023 | ||
| Corporate Officer |
Oct 23, 2023 | ||
| Corporate Director | Oct 23, 2023 | ||
| Hal Harrison |
Corporate Officer |
Jun 25, 2024 | |
| Corporate Director | Jun 25, 2024 | ||
| Corporate Officer | Jun 25, 2024 | ||
| Darlene Holifield |
Corporate Officer | Apr 24, 2014 | |
| Pricilla Mack |
Corporate Officer | Jul 26, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01-1029 | Other | AL | MEDICARE PTAN |
| 01-1030 | Other | AL | MEDICARE PTAN |
Other providers in Centreville, AL
- Cynthia Rene Britt
- Laporsha Shana Brown
- Jasmine Bush
- Cahaba Medical Care Foundation
- Cahaba Medical Care Foundation
- Cahaba Medical Care Foundation
- Cahaba Medical Care Foundation
- Cahaba Medical Care Foundation
- Cahaba Medical Care of Al., LLC
- Cahaba Medical Care, PC
All providers in Centreville, AL · Federally Qualified Health Center (FQHC) in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.