NPIMap

Organization Active NPI

Southern Rural Health Care Consortium, Inc.

  • Federally Qualified Health Center (FQHC)
  • Decatur, AL
National Provider Identifier
1609948306
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHERN RURAL HEALTH CARE CONSORTIUM, INC.
Practice address
1304 13TH Avenue S.E.
Suite F
Decatur, AL 35601
Phone
(256) 332-1631
Fax
(256) 332-4600
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Authorized official

Name
Mrs. Kathy L Hall
Title
Executive Director
Phone
(256) 332-1631

Specialties & licenses 1

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

Addresses

Primary practice location

1304 13TH Avenue S.E.
Suite F
Decatur, AL 35601

Mailing address

PO Box 970
Russellville, AL 35653-0970
Phone (256) 332-1631

Other identifiers 3

IdentifierTypeStateIssuer
01200280OtherBLUE CROSS BLUE SHIELD AL
630005001MedicaidAL
01-1902OtherALMEDICARE #

Other names 1

  • Decatur Primary Care Other name

National Provider Directory

National Provider Directory

Locations

1304 13th Ave SE
Ste F
Decatur, AL 35601
Phone (256) 332-1631

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1609948306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356530970",
            "telephone_number": "256-332-1631",
            "fax_number": "256-332-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 13TH AVENUE S.E.",
            "address_2": "SUITE F",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "35601",
            "telephone_number": "256-332-1631",
            "fax_number": "256-332-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN RURAL HEALTH CARE CONSORTIUM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "256-332-1631",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AL",
            "identifier": "01200280",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630005001",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE #",
            "identifier": "01-1902",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Decatur Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.