East Alabama Family Practice, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO-350 Issued in AL

Legal business name

EAST ALABAMA FAMILY PRACTICE, P.C.

Practice address

2214 Gateway Dr
Suite C
Opelika, AL 36801-1500

Phone

(334) 741-0075

Fax

(334) 741-4075

NPI assigned

Nov 21, 2006

Last updated

Dec 22, 2022By 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. Keith Lyle Fuller, D.O.NPI 1730125527

Title

President

Phone

(334) 741-0075

Specialties & licenses 1

Addresses

Other identifiers 1

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14759/brand/1/csg/1/fhir/r4

Practitioners 7

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.

• Keith Lyle Fuller, D.O.

  • Family Medicine Physician
  • Opelika, AL
  • NPI 1730125527
  Medicare reassignment Care Compare group Authorized official
• Laura Walton Bell, CRNP

  • Family Nurse Practitioner
  • Opelika, AL
  • NPI 1629519558
  Medicare reassignment Care Compare group NPD
• Ashley Prosser Dorn, CRNP

  • Family Nurse Practitioner
  • Opelika, AL
  • NPI 1861226227
  Medicare reassignment Care Compare group NPD
• Anna Petty Gardner, CRNP

  • Family Nurse Practitioner
  • Opelika, AL
  • NPI 1265008312
  Medicare reassignment Care Compare group NPD
• Elizabeth Anne Smith Kelley, CRNP

  • Family Nurse Practitioner
  • Opelika, AL
  • NPI 1700261591
  Medicare reassignment Care Compare group NPD
• Dorothea Brady Harris, CRNP

  • Nurse Practitioner
  • Auburn, AL
  • NPI 1578923520
  Medicare reassignment NPD
• Jessica Melvin, PA

  • Physician Assistant
  • Montgomery, AL
  • NPI 1023357621
  Medicare reassignment

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1386719193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 GATEWAY DR",
            "address_2": "SUITE C",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368011500",
            "telephone_number": "334-741-0075",
            "fax_number": "334-741-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 GATEWAY DR",
            "address_2": "SUITE C",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368011500",
            "telephone_number": "334-741-0075",
            "fax_number": "334-741-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST ALABAMA FAMILY PRACTICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "LYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-741-0075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO-350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529602340",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Alabama Cardiac and Thoracic Surgery
• East Alabama Dental Group, LLC
• East Alabama Ear, Nose, & Throat, PC
• East Alabama EMS, LLC
• East Alabama Endocrinology, P.C.
• East Alabama Health Services LLC (Unity Wellness Center)
• East Alabama Heart and Vascular, LLC (Heart and Lung Surgeons of East Alabama)
• East Alabama Heart and Vascular, LLC (Pinnacle Cardiovascular Associates)
• East Alabama Homemed LLC (HomeMed LLC)
• East Alabama Internal Medicine,PC

• Family Medicine Physician in Opelika, AL
• Providers in Opelika, 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 Dec 22, 2022; 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.