NPIMap

Organization Active NPI

Health Services, Inc

Doing business as Montgomery Primary Care

  • Federally Qualified Health Center (FQHC)
  • Montgomery, AL
National Provider Identifier
1528082336
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTH SERVICES, INC
Doing business as
Montgomery Primary Care
Practice address
3060 Mobile Hwy
Montgomery, AL 36108-4027
Phone
(334) 293-6670
Fax
(334) 293-6676
NPI assigned
Jul 26, 2006
Last updated
Nov 29, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Authorized official

Name
Susie Ann Beal
Title
Cfo
Phone
(334) 420-5001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3060 Mobile Hwy
Montgomery, AL 36108-4027

Mailing address

PO Box 70365
Montgomery, AL 36107-0365
Phone (334) 263-2301

Other names 1

  • Montgomery Primary Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041201000952 AL Part B Supplier - Clinic/Group Practice 1557324811 Receives reassigned benefits from 53 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clanton, AL; Ramer, AL; Montgomery, AL; Hayneville, AL; Eclectic, AL; Autaugaville, AL
O20100707000180 AL Part A Provider - Federally Qualified Health Center (FQHC) 1557324811 Practice locations: Montgomery, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528082336. Details of each certification follow.

Federally qualified health center certification: CCN 011876

Legal name
HEALTH SERVICES INC
Doing business as
MONTGOMERY PRIMARY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 22, 1994
Last certification
Jul 22, 1994
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Apr 25, 1968 in AL
Enrollment address
3058 Mobile Hwy
Montgomery, AL 36108-4027
Related CCNs
011801

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Health SVC Inc19 organizations share this tax ID, including this one
Part of
Health SVC Inc

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Jacqueline Navidad Individual Corporate DirectorBoard Member Feb 24, 2016
Vicki C Ingram Individual W-2 Managing EmployeeProvider Enrollment,Credentialin Apr 15, 2019
James a. Brown Individual Corporate DirectorBoard Member Jan 4, 1996
Sandra Savage-Bell Individual Corporate DirectorBoard Member Jan 4, 2007
William Abe Abernathy Individual Corporate DirectorBoard Member Jan 1, 2015
Helenor Bell Individual Corporate DirectorBoard Member Jun 27, 2018
Classie S. Thomas Individual Corporate DirectorBoard Member Jan 4, 2001
Molly Stone Individual Corporate DirectorBoard Member Jan 1, 2015
Claude Douglas Individual Corporate DirectorBoard Member Jan 4, 1997
Gilbert Darrington Individual Corporate DirectorCeo Oct 1, 2015
Janice Ann Durr Individual Corporate DirectorBoard Member Jan 4, 2004
Choona Lang Individual Corporate DirectorBoard Member May 26, 2015
Nicolette Peluso Russell Individual Corporate DirectorBoard Member Jan 4, 2005
Debra Caldwell Bush Individual Corporate DirectorBoard Member Mar 20, 2019
Susie Jones Individual Corporate OfficerChief Financial Officer Oct 8, 2016
W-2 Managing EmployeeCfo Oct 15, 2016
Juanita Owes Individual Corporate DirectorBoard Member Jan 4, 2001
Terry Reid Individual Corporate OfficerChief Operating Officer Jun 4, 2018

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Highland Gardens School Based Health CenterMontgomery, AL, CCN 011056 Federally qualified health center 5% Or Greater Direct Ownership Interest Apr 1, 2019
Bellingrath School Based Health CenterMontgomery, AL, CCN 011059 Federally qualified health center 5% Or Greater Direct Ownership Interest Apr 1, 2019
Montevallo Family Health CenterMontevallo, AL, CCN 011066 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 30, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Health Services Inc

    dba Montevallo Family Health Center

    • Federally Qualified Health Center (FQHC)
    • Montevallo, AL
    • NPI 1891257390

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Health Services, Inc

    dba Bellingrath School Based Clinic

    • Federally Qualified Health Center (FQHC)
    • Montgomery, AL
    • NPI 1982172367

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Health Services, Inc.

    dba Highland Gardens School Based Health Center

    • Federally Qualified Health Center (FQHC)
    • Montgomery, AL
    • NPI 1427521962

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1528082336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70365",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361070365",
            "telephone_number": "334-263-2301",
            "fax_number": "334-264-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 MOBILE HWY",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361084027",
            "telephone_number": "334-293-6670",
            "fax_number": "334-293-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH SERVICES INC.",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "334-420-5001"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Montgomery Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.