Clay County Medical Clinics, P.C.
Organization Active NPI Specialist · Lineville, AL
NPI 1376539635 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1376539635
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- CLAY COUNTY MEDICAL CLINICS, P.C.
- Practice address
- 60026 Highway 49
Lineville, AL 36266-4735 - Phone
- (256) 396-2141
- Fax
- (256) 396-5884
- NPI assigned
- Sep 22, 2005
- Organization subpart
- No
Authorized official
- Name
- Dr. George C Smith Sr., M.C.
- Title
- President
- Phone
- (256) 396-2141
Practitioners 6
-
George C Smith Jr., M.D.
-
Ashley Smith Lane, M.D.
-
George C Smith Sr., M.D.
-
Shellie Ray, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D0304639 | Clay County Medical Clinic PC | Certificate of waiver | Dec 31, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050919000549 | AL | Part B Supplier - Clinic/Group Practice | 6204860398 |
Receives reassigned benefits from 5 practitioners Practice locations: Lineville, AL |
National Provider Directory
Locations
60026 Highway 49
Lineville, AL 36266
Phone (205) 396-2141
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
60026 Highway 49
Lineville, AL 36266-4735
Mailing address
PO Box 98
Lineville, AL 36266-0098
Phone (256) 396-2141
Other providers in Lineville, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.