Jackson County Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19311 Issued in AL

Legal business name

JACKSON COUNTY FAMILY MEDICINE LLC

Practice address

508 Harley St
Ste C
Scottsboro, AL 35768-4294

Phone

(256) 259-5537

Fax

(256) 259-3189

NPI assigned

Mar 12, 2014

Last updated

Apr 14, 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. William Hardin Coleman Jr., M.D.NPI 1427141241

Title

President

Phone

(256) 259-5537

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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.

• William Hardin Coleman Jr., M.D.

  • Family Medicine Physician
  • Scottsboro, AL
  • NPI 1427141241
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1366868531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 HARLEY ST",
            "address_2": "STE C",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684294",
            "telephone_number": "256-259-5537",
            "fax_number": "256-259-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 HARLEY ST",
            "address_2": "STE C",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684294",
            "telephone_number": "256-259-5537",
            "fax_number": "256-259-3189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-12",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "HARDIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-259-5537",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "19311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Immh Scottsboro LLC
• Younus M Ismail, M.D.
• Bethany Lynn Ivey, PT, DPT
• Jackson County Board of Education
• Jackson County Family Care Clinic
• Jackson County Health Care Authority (Highlands Medical Center)
• Jackson County Health Dept Adult Immun
• Jackson County Health Dept AIDS
• Jackson County Health Dept Child
• Jackson County Health Dept Epsdt

• Family Medicine Physician in Scottsboro, AL
• Providers in Scottsboro, 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 Apr 14, 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.