NPIMap

Organization Active NPI

Isbell Medical Group, P.C.

  • Multi-Specialty Clinic/Center
  • Fort Payne, AL
National Provider Identifier
1457411043
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ISBELL MEDICAL GROUP, P.C.
Practice address
550 Medical Center Dr SW
Fort Payne, AL 35968-3418
Phone
(256) 845-8885
Fax
(256) 845-9546
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Authorized official

Name
Dr. John Blakely Isbell, M.D.NPI 1487608204
Title
President
Phone
(256) 845-8885

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

550 Medical Center Dr SW
Fort Payne, AL 35968-3418

Mailing address

550 Medical Center Dr SW
PO Box 680199
Fort Payne, AL 35968-3418
Phone (256) 845-8885

Other identifiers 1

IdentifierTypeStateIssuer
528301650MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040427000961 AL Part B Supplier - Clinic/Group Practice 0446247902 Receives reassigned benefits from 10 practitioners
Practice locations: Fort Payne, AL
O20180228002310 AL Part A Provider - Rural Health Clinic 0446247902 Practice locations: Fort Payne, AL

Rural health clinic certification: CCN 018932

Legal name
ISBELL MEDICAL GROUP PC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 17, 2018
Last certification
Jan 28, 2026
Ownership / control type
1B
Organization structure
PartnershipProprietary
Incorporated
Feb 28, 2013 in AL
Enrollment address
550 Medical Center Dr SW
Fort Payne, AL 35968-3418

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0698561Isbell Medical Group PC550 Medical Center Drive SW, Fort Payne, AL 35968Certificate of waiverOct 7, 2026

National Provider Directory

National Provider Directory

Locations

550 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-6293

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Warren W Scott Individual 5% Or Greater Direct Ownership Interest Feb 1, 2018 20%
W-2 Managing Employee Feb 1, 2018
Steven Coulter Individual 5% Or Greater Direct Ownership Interest Feb 1, 2018 20%
W-2 Managing Employee Feb 1, 2018
John B Isbell Individual 5% Or Greater Direct Ownership Interest Feb 1, 2018 20%
W-2 Managing Employee Feb 1, 2018
Tamera Bearden Individual W-2 Managing EmployeeAccounting Manager Feb 1, 2018
Angela E Chaney Individual 5% Or Greater Direct Ownership Interest Feb 1, 2018 20%
W-2 Managing Employee Feb 1, 2018
Robert M Story Individual 5% Or Greater Direct Ownership Interest Feb 1, 2018
W-2 Managing Employee Feb 1, 2018

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1457411043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MEDICAL CENTER DR SW",
            "address_2": "PO BOX 680199",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683418",
            "telephone_number": "256-845-8885",
            "fax_number": "256-845-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MEDICAL CENTER DR SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683418",
            "telephone_number": "256-845-8885",
            "fax_number": "256-845-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISBELL MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-01-17",
        "status": "A",
        "authorized_official_last_name": "ISBELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BLAKELY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-845-8885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528301650",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.