NPIMap

Organization Active NPI

Prime Healthcare Services-Gadsden Physician Management LLC

  • Family Medicine Physician
  • Gadsden, AL
National Provider Identifier
1356731467
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIME HEALTHCARE SERVICES-GADSDEN PHYSICIAN MANAGEMENT LLC
Practice address
303 Bay St Ste 401
Gadsden, AL 35901-5203
Phone
(256) 467-4731
Fax
(256) 467-4734
NPI assigned
Jan 27, 2015
Last updated
Oct 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

303 Bay St Ste 401
Gadsden, AL 35901-5203

Mailing address

303 Bay St Ste 401
Gadsden, AL 35901-5203
Phone (256) 467-4731

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150806011161 AL Part B Supplier - Clinic/Group Practice 7113231945 Receives reassigned benefits from 122 practitioners
Practice locations: Gadsden, AL; 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
01D2266791Prime Healthcare Services-Gadsden Physician Manage303 Bay Street, Gadsden, AL 35901Certificate of waiverAug 15, 2026

National Provider Directory

National Provider Directory

Locations

106 Bay St
Gadsden, AL 35901
Phone (256) 546-7778

1401B Rainbow Dr
Gadsden, AL 35901
Phone (256) 543-9497

303 Bay St
Ste 203
Gadsden, AL 35901
Phone (256) 546-3345

303 Bay St
Ste 404
Gadsden, AL 35901
Phone (256) 467-4731

304 S 4th St
Gadsden, AL 35901
Phone (256) 543-1066

404 S 6th St
Gadsden, AL 35901

700 Chastain Blvd W
Glencoe, AL 35905
Phone (256) 492-8113

1642A Pelham Rd S
Jacksonville, AL 36265
Phone (256) 543-1222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10998/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 124

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 124

NPI Registry JSON

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1356731467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 BAY ST STE 401",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015203",
            "telephone_number": "256-467-4731",
            "fax_number": "256-467-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BAY ST STE 401",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015203",
            "telephone_number": "256-467-4731",
            "fax_number": "256-467-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES-GADSDEN PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.