Charles Henderson Memorial Association
Organization Active NPI Clinic/Center · Troy, AL
NPI 1346207131 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1346207131
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- CHARLES HENDERSON MEMORIAL ASSOCIATION
- Practice address
- 1300 Highway 231 S
Troy, AL 36081-3058 - Phone
- (334) 566-7600
- Fax
- (334) 566-1445
- NPI assigned
- Apr 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Jerri B Smith
- Title
- Financial Manager
- Phone
- (334) 566-7600
Practitioners 11
-
Judy L Bazzell, CRNP
-
Gwendolyn Calhoon, FNP-C
-
Kelli Kervin Cleveland, CRNP
-
Amy B Flowers, DMD
-
Eddie C. Jackson, DMD
-
Katelyn Roe McKenzie, CRNP
-
Brittany Nicole Owings, CRNP
-
Yolanda A Patterson, M.D.
-
Barbara W Thompson, DDS
-
Christy Lynn Ott McKay, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051122000686 | AL | Part B Supplier - Clinic/Group Practice | 2264452069 | Practice locations: Troy, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
1300 Highway 231 S
Troy, AL 36081-3058
Mailing address
PO Box 928
Troy, AL 36081-0928
Phone (334) 566-7600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D493 | Other | AL | BCBS OF ALABAMA |
Other names
- Charles Henderson Child Health Center
Other providers in Troy, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.