Organization Active NPI

Doctors Med Care of Jacksonville, P.C.

  • Family Medicine Physician
  • Jacksonville, AL
National Provider Identifier
1326079922
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DOCTORS MED CARE OF JACKSONVILLE, P.C.
Practice address
1505 Pelham Rd S
Ste 2
Jacksonville, AL 36265-3706
Phone
(256) 435-7300
Fax
(256) 435-7305
NPI assigned
Jul 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Akil Taher
Title
Secretary
Phone
(256) 435-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1505 Pelham Rd S
Ste 2
Jacksonville, AL 36265-3706

Mailing address

1505 Pelham Rd S
Ste 2
Jacksonville, AL 36265-3706
Phone (256) 435-7300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051207000193 AL Part B Supplier - Clinic/Group Practice 0446270318 Receives reassigned benefits from 10 practitioners
Practice locations: Jacksonville, AL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1045512Doctors Med Care of Jacksonville PC1505 Pelham Road S Suite 2, Jacksonville, AL 36265ComplianceApr 3, 2028

National Provider Directory

National Provider Directory

Locations

1505 Pelham Rd S
Ste 2
Jacksonville, AL 36265
Phone (256) 435-7300

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326079922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 PELHAM RD S",
            "address_2": "STE 2",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653706",
            "telephone_number": "256-435-7300",
            "fax_number": "256-435-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 PELHAM RD S",
            "address_2": "STE 2",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653706",
            "telephone_number": "256-435-7300",
            "fax_number": "256-435-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS MED CARE OF JACKSONVILLE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAHER",
        "authorized_official_first_name": "AKIL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "256-435-7300",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.