NPIMap

Organization Active NPI

Brewton Medical Center, LLC

  • Family Medicine Physician
  • Brewton, AL
National Provider Identifier
1336196856
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BREWTON MEDICAL CENTER, LLC
Practice address
1121 Belleville Ave
Brewton, AL 36426-1505
Phone
(251) 867-6071
Fax
(251) 867-5999
NPI assigned
May 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Authorized official

Name
Victor Hunt Jr.
Title
Administrator
Phone
(251) 867-6071

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

1121 Belleville Ave
Brewton, AL 36426-1505

Mailing address

PO Box 648
Brewton, AL 36427-0648
Phone (251) 867-6071

Other identifiers 2

IdentifierTypeStateIssuer
000060008MedicaidAL
CB0244OtherALMEDICARE/RAILROAD MEDICAR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1336196856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364270648",
            "telephone_number": "251-867-6071",
            "fax_number": "251-867-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 BELLEVILLE AVE",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261505",
            "telephone_number": "251-867-6071",
            "fax_number": "251-867-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREWTON MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "251-867-6071",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000060008",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/RAILROAD MEDICAR",
            "identifier": "CB0244",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewton, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.