NPIMap

Organization Active NPI

Cullman County Medical Clinic Inc

  • Family Medicine Physician
  • Cullman, AL
National Provider Identifier
1609879220
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CULLMAN COUNTY MEDICAL CLINIC INC
Practice address
1910 Cherokee Ave SW
Cullman, AL 35055-5502
Phone
(256) 739-3500
Fax
(256) 736-1093
NPI assigned
May 27, 2005
Last updated
Aug 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Mrs. Shana Jochum Hice
Title
Director, Physician Practices
Phone
(256) 736-5328

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X NU
Hospitalist Physician 208M00000X NU

Addresses

Primary practice location

1910 Cherokee Ave SW
Cullman, AL 35055-5502

Mailing address

1910 Cherokee Ave. SW
Cullman, AL 35055
Phone (256) 739-3500

Other identifiers 1

IdentifierTypeStateIssuer
529907580MedicaidAL

National Provider Directory

National Provider Directory

Locations

1908 Cherokee Ave SW
Cullman, AL 35055
Phone (256) 734-4700

1912 Cherokee Ave SW
Ste 1600
Cullman, AL 35055
Phone (256) 736-1492

1912 Cherokee Ave SW
Ste 2200
Cullman, AL 35055
Phone (256) 736-1405

1912 Cherokee Ave SW
Ste 3100
Cullman, AL 35055
Phone (256) 734-1012

806 Main St NE
Hanceville, AL 35077
Phone (256) 352-9566

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1609879220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 CHEROKEE AVE. SW",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "35055",
            "telephone_number": "256-739-3500",
            "fax_number": "256-775-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 CHEROKEE AVE SW",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350555502",
            "telephone_number": "256-739-3500",
            "fax_number": "256-736-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULLMAN COUNTY MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "HICE",
        "authorized_official_first_name": "SHANA",
        "authorized_official_middle_name": "JOCHUM",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICIAN PRACTICES",
        "authorized_official_telephone_number": "256-736-5328",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529907580",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.