NPIMap

Organization Active NPI

Dale Medical Center

Doing business as Claybank Family Medical

  • Family Medicine Physician
  • Ozark, AL
National Provider Identifier
1497893408
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DALE MEDICAL CENTER
Doing business as
Claybank Family Medical
Practice address
1519 Andrews Ave
Ozark, AL 36360-3719
Phone
(334) 774-7610
Fax
(334) 774-7251
NPI assigned
Feb 2, 2007
Last updated
Feb 6, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
DALE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Authorized official

Name
Rick Wright
Title
Cfo
Phone
(334) 774-2601

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU Primary
Pulmonary Disease Physician 207RP1001X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

1519 Andrews Ave
Ozark, AL 36360-3719

Mailing address

PO Box 863
Ozark, AL 36361-0863
Phone (334) 443-1211

Other identifiers 1

IdentifierTypeStateIssuer
529908700MedicaidAL

Other names 2

  • Claybank Family Medical Doing business as
  • Statmed Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000202 AL Part B Supplier - Clinic/Group Practice 3476466327 Receives reassigned benefits from 47 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ozark, AL

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

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
01D0932199Claybank Family Medicine1519 Andrews Avenue, Ozark, AL 36360Certificate of waiverFeb 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dale Medical Center13 organizations share this tax ID, including this one
Part of
Dale Medical Center

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

145 Katherine Ave
Ozark, AL 36360
Phone (334) 774-5100

Practitioners & affiliated clinicians

Practitioners 6

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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1497893408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363610863",
            "telephone_number": "334-443-1211",
            "fax_number": "334-443-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 ANDREWS AVE",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363603719",
            "telephone_number": "334-774-7610",
            "fax_number": "334-774-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DALE MEDICAL CENTER",
        "enumeration_date": "2007-02-02",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "334-774-2601"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529908700",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Claybank Family Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Statmed",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ozark, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.