Realm Incorporated

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

DO190 Issued in AL

Legal business name

REALM INCORPORATED

Doing business as

Nathanael Medical Center

Practice address

1435 W Main St
Dothan, AL 36301-1311

Phone

(334) 702-8872

Fax

(334) 702-8957

NPI assigned

Jul 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Sammy Banner, D.O.

Title

President

Phone

(334) 702-8872

Specialties & licenses 1

Addresses

Other names 1

• NATHANAEL MEDICAL CENTER Doing business as

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1558616029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8307",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363040307",
            "telephone_number": "334-702-8872",
            "fax_number": "334-702-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011311",
            "telephone_number": "334-702-8872",
            "fax_number": "334-702-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALM INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "BANNER",
        "authorized_official_first_name": "SAMMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-702-8872",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AL",
            "license": "DO190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NATHANAEL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Saad Rashid
• Yasir Rashid, MD
• Sandesh Raut
• Ray of Hope Counseling and Grief Center
• Reach Kidney Care LLC (Dothan REACH CKD Clinic)
• Neeta Muddasani Reddy
• Puli Gopal Reddy, MD
• Starla Reeder, MCD, CCC/SLP
• Sydney Mims Reeder, CRNA
• Nikeli Sharell Reeves, MSW

• Primary Care Clinic/Center in Dothan, AL
• Providers in Dothan, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.