Prattville Primary Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10401 Issued in AL

Legal business name

PRATTVILLE PRIMARY CARE LLC

Practice address

461 E Main Street
Prattville, AL 36067

Phone

(334) 365-2205

Fax

(334) 361-7975

NPI assigned

Jan 29, 2007

Last updated

Feb 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Danny P Ingram, MDNPI 1689608747

Title

President

Phone

(334) 365-2205

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

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.

• Danny P Ingram, MD

  • Family Medicine Physician
  • Prattville, AL
  • NPI 1689608747
  Authorized official Same address or phone
• Charles Garrison Cloutier, MD

  • Family Medicine Physician
  • Prattville, AL
  • NPI 1427044395
  NPD

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1326184029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 681330",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360681330",
            "telephone_number": "334-365-2205",
            "fax_number": "334-361-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 E MAIN STREET",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "36067",
            "telephone_number": "334-365-2205",
            "fax_number": "334-361-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATTVILLE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "DANNY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-365-2205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "10401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51030008",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000030008",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Premier Eye Associates Prattville LLC
• Premise Health of Alabama Medical PC (IP Prattville Mill Health Center)
• Premise Health of Alabama Medical PC (City of Prattville)
• Prescription Eyewear, Inc.

• Family Medicine Physician in Prattville, AL
• Providers in Prattville, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.