NPIMap

Organization Active NPI

Tennessee Valley Family Practice Associates PC

  • Family Medicine Physician
  • Bridgeport, AL
National Provider Identifier
1386075976
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7850 Issued in AL
Legal business name
TENNESSEE VALLEY FAMILY PRACTICE ASSOCIATES PC
Practice address
47053 Al Highway 277
Suite C
Bridgeport, AL 35740-7205
Phone
(256) 437-0555
NPI assigned
Dec 6, 2013
Last updated
Jan 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Authorized official

Name
Jerry Chris Blevins, MD
Title
Owner
Phone
(256) 437-0555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7850 AL Primary

Addresses

Primary practice location

47053 Al Highway 277
Suite C
Bridgeport, AL 35740-7205

Mailing address

47053 Al Highway 277
Suite C
Bridgeport, AL 35740-7205
Phone (256) 437-0555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1386075976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47053 AL HIGHWAY 277",
            "address_2": "SUITE C",
            "city": "BRIDGEPORT",
            "state": "AL",
            "postal_code": "357407205",
            "telephone_number": "256-437-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47053 AL HIGHWAY 277",
            "address_2": "SUITE C",
            "city": "BRIDGEPORT",
            "state": "AL",
            "postal_code": "357407205",
            "telephone_number": "256-437-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE VALLEY FAMILY PRACTICE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "BLEVINS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "CHRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-437-0555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "7850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.