Active NPI
Gana Holdings, LLC
- Internal Medicine Physician
- Snead, AL
National Provider Identifier
1396375267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- GANA HOLDINGS, LLC
- Practice address
- 180 Medical St
Snead, AL 35952-6468 - Phone
- (053) 864-3412
- Fax
- (205) 466-7437
- NPI assigned
- Jan 20, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Enrico D Gaspar, MD
- Title
- Owner
- Phone
- (256) 840-8181
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Acute Care Nurse Practitioner | 363LA2100X | |||
| Adult Health Nurse Practitioner | 363LA2200X | |||
| Gerontology Nurse Practitioner | 363LG0600X |
Addresses
Primary practice location
180 Medical St
Snead, AL 35952-6468
Mailing address
PO Box 555
Snead, AL 35952-0555
Phone (205) 386-4341
Other names 1
- United Doctors Family Medical Center - Snead
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200807000386 | AL | Part B Supplier - Clinic/Group Practice | 3476978412 |
Receives reassigned benefits from 14 practitioners Practice locations: Snead, AL |
| O20210114001331 | AL | Part A Provider - Rural Health Clinic | 3476978412 | Practice locations: Snead, AL |
Rural health clinic certification: CCN 018955
- Legal name
- GANA HOLDINGS, LLC
- Doing business as
- UNITED DOCTORS FAMILY MEDICAL CENTER - SNEAD
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 9, 2021
- Last certification
- Jun 11, 2021
- Ownership / control type
- 1A
- Organization structure
- LLC
- Enrollment address
- 180 Medical St
Snead, AL 35952-6468
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2183412 | United Doctors Family Medical Center Snead | Certificate of waiver | May 4, 2028 |
National Provider Directory
National Provider DirectoryLocations
600 Corley Ave
Boaz, AL 35957
Phone (256) 503-8380
Ownership & related parties
All disclosed owners & managing parties 1
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Enrico Deseo Y. Gaspar | 5% Or Greater Direct Ownership Interest | Dec 11, 2019 | 100% |
| Corporate Officer | Dec 11, 2019 | 100% | |
| Operational/Managerial Control | Dec 11, 2019 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Boaz, AL
- NPI 1497740492
5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 14
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Altoona, AL
- NPI 1184439184
AL, Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1649462400000",
"number": "1396375267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 555",
"city": "SNEAD",
"state": "AL",
"postal_code": "359520555",
"telephone_number": "205-386-4341",
"fax_number": "205-466-7437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 MEDICAL ST",
"city": "SNEAD",
"state": "AL",
"postal_code": "359526468",
"telephone_number": "053-864-3412",
"fax_number": "205-466-7437"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GANA HOLDINGS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-01-20",
"last_updated": "2022-04-09",
"certification_date": "2022-04-09",
"status": "A",
"authorized_official_last_name": "GASPAR",
"authorized_official_first_name": "ENRICO",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "256-840-8181",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Acute Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Gerontology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "United Doctors Family Medical Center - Snead",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Snead, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.