NPIMap

Organization Active NPI

Anniston Medical Clinic PC

  • Internal Medicine Physician
  • Anniston, AL
National Provider Identifier
1619080017
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ANNISTON MEDICAL CLINIC PC
Practice address
1010 Christine Ave
Anniston, AL 36207-5710
Phone
(256) 236-5631
Fax
(256) 241-2241
NPI assigned
Aug 17, 2006
Last updated
Mar 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Authorized official

Name
Vishala Chindalore, M.D.NPI 1083635015
Title
Rheumatologist
Phone
(256) 236-5631

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X AL
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X AL Primary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X AL
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X AL
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X AL
Multi-Specialty Clinic/Center 261QM1300X AL

Addresses

Primary practice location

1010 Christine Ave
Anniston, AL 36207-5710

Mailing address

PO Box 2127
Anniston, AL 36202-2127
Phone (256) 236-5631

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040220000728 AL Part B Supplier - Clinic/Group Practice 0244125854 Receives reassigned benefits from 20 practitioners
Practice locations: Anniston, AL
O20100930065456 AL DME Supplier - Multi-Specialty - Physician 0244125854 Practice locations: Anniston, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0304515Anniston Medical Clinic1010 Christine Ave, Anniston, AL 36207Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1900 Leighton Ave
Ste 205LON
Anniston, AL 36207

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1619080017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2127",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362022127",
            "telephone_number": "256-236-5631",
            "fax_number": "256-241-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 CHRISTINE AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362075710",
            "telephone_number": "256-236-5631",
            "fax_number": "256-241-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNISTON MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "CHINDALORE",
        "authorized_official_first_name": "VISHALA",
        "authorized_official_title_or_position": "RHEUMATOLOGIST",
        "authorized_official_telephone_number": "256-236-5631",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "AL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.