Family Practice of Jacksonville PC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

7306 Issued in AL

Legal business name

FAMILY PRACTICE OF JACKSONVILLE PC

Practice address

1881 Hwy 21 South
Jacksonville, AL 36265

Phone

(256) 435-3035

Fax

(256) 435-9111

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Kewal K Verma, MD

Title

President

Phone

(256) 435-3035

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Vishwanath Mukkamalla Reddy, MD

  • Internal Medicine Physician
  • Anniston, AL
  • NPI 1952375354
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1568571602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 777",
            "address_2": "1881 HWY 21 SOUTH",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "36265",
            "telephone_number": "256-435-3035",
            "fax_number": "256-435-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 HWY 21 SOUTH",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "36265",
            "telephone_number": "256-435-3035",
            "fax_number": "256-435-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE OF JACKSONVILLE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "VERMA",
        "authorized_official_first_name": "KEWAL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-435-3035",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "AL",
            "license": "7306",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "7306",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "01D0689490",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Leigh Easterling, LMSW
• Elevate M E Counseling, LLC
• Stacy Ellett, LPN
• Eric Lafayette D.M.D LLC
• Bonne L Evans
• Muhamad Mazen Festok, MD
• Lisa T Foney, CCMA
• Diana C. Ford, MA, LPC
• Garrett Counseling and Consulting
• Ashley Lynn Garrett, LPC, MS, ED.S

• Allergy & Immunology Physician in Jacksonville, AL
• Providers in Jacksonville, AL by specialty
• Allergy & Immunology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.