NPIMap

Individual provider Active NPI

Boyde J Harrison, MD

  • Family Medicine Physician
  • Haleyville, AL
National Provider Identifier
1619908571
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10063 Issued in AL
Practice address
904 26TH Street
Haleyville, AL 35565
Phone
(205) 486-5234
Fax
(205) 486-5232
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10063 AL Primary

Addresses

Primary practice location

904 26TH Street
Haleyville, AL 35565

Mailing address

PO Box 655
Haleyville, AL 35565
Phone (205) 486-5234

Other identifiers 1

IdentifierTypeStateIssuer
000030197MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090422000225 AL Practitioner - Family Practice 3375445182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russellville Hospital Inc.Group PAC ID 3476878489, 66 clinicians
Boyde J Harrison MD PCGroup PAC ID 9638198021, 5 clinicians

Practice addresses (Care Compare)

15225 Hwy 43
Suite I
Russellville, AL 35653-1969
Phone (256) 331-2700

904 26TH St
Haleyville, AL 35565-1719
Phone (205) 786-5234

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Moulton, AL, CCN 017071
  • Keller Home Care Home health agency, Red Bay, AL, CCN 017125
  • Aveanna Home Health Home health agency, Hoover, AL, CCN 017153
  • Centerwell Home Health Home health agency, Jasper, AL, CCN 017170
  • Enhabit Home Health Home health agency, Muscle Shoals, AL, CCN 017326
  • Southeast Hospice Network Hospice, Jasper, AL, CCN 011663
  • Aveanna Hospice of Cullman Hospice, Cullman, AL, CCN 011643
  • Hospice of North Alabama, LLC Hospice, Huntsville, AL, CCN 011622
  • Walker Baptist Medical Center Hospital, Jasper, AL, CCN 010089
  • Lakeland Community Hospital Hospital, Haleyville, AL, CCN 011311
  • Lakeland Community Hospital Hospital, Haleyville, AL, CCN 010125
  • North Mississippi Health Services - South Marion Hospital, Winfield, AL, CCN 010086
  • Helen Keller Hospital Hospital, Sheffield, AL, CCN 010019
  • Ridgeview Health Services, Inc Nursing home, Jasper, AL, CCN 015155
  • Haleyville Health Care Center Nursing home, Haleyville, AL, CCN 015157
  • Shadescrest Health Care Center Nursing home, Jasper, AL, CCN 015114
  • Hendrix Health and Rehabilitation Nursing home, Double Springs, AL, CCN 015138
  • Ridgewood Health Services, Inc. Nursing home, Jasper, AL, CCN 015315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10063ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Russellville Hospital Inc Family Medicine CurrentSince Mar 1, 2024 Accepting new patients
Russellville Hospital Inc Family Medicine CurrentSince Mar 1, 2024 Accepting new patients
Haleyville SNF Operations LLC Past Accepting new patients
Lakeland Physician Practices LLC Family Medicine Past Accepting new patients
Walker Rehabilitation Center, Inc Past Accepting new patients
Ridgeview Health Services, Inc. Past Accepting new patients
Hendrix Health Care Center, Inc. Past Accepting new patients
Ridgewood Health Services, Inc. Past Accepting new patients
Family Rehab Services, Inc PastSince Mar 25, 2004 Accepting new patients
Shadescrest Health Care Center Past Accepting new patients
Bamah Hospice USA, Inc PastSince Jan 15, 2014 Accepting new patients
Lakeland Community Hospital, Inc. Past Accepting new patients
Caregivers of Pleasant Grove Inc Past Accepting new patients

Locations

15225 Highway 43
Ste I
Russellville, AL 35653
Phone (256) 331-2700

Interoperability endpoints

  • Direct secure messaging: kxp2251@yourcarecommunity.org

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ridgeview Health Services IncJasper, AL, CCN 015155 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 16, 2005
Sep 16, 2005
Sunset ManorGuin, AL, CCN 015149 Skilled nursing facility Operational/Managerial Control
Trustee of the SNF
Adp of the SNF		 Feb 1, 2026
Feb 1, 2026
Feb 1, 2026
Shadescrest Health Care CenterJasper, AL, CCN 015114 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2023
Jan 1, 2023
Walker Rehabilitation Center, IncCarbon Hill, AL, CCN 015408 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF		 Feb 17, 2025
Jul 8, 2025
Ridgewood Health Services, Inc.Jasper, AL, CCN 015315 Skilled nursing facility Adp of the SNF Oct 1, 2013
Haleyville Rehabilitation and Healthcare CenterHaleyville, AL, CCN 015157 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 24, 2023
Mar 24, 2023

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 18

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619908571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 655",
            "city": "HALEYVILLE",
            "state": "AL",
            "postal_code": "35565",
            "telephone_number": "205-486-5234",
            "fax_number": "205-486-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 26TH STREET",
            "city": "HALEYVILLE",
            "state": "AL",
            "postal_code": "35565",
            "telephone_number": "205-486-5234",
            "fax_number": "205-486-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "BOYDE",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "10063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000030197",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haleyville, AL

Sources for this page

Verify at the official NPI Registry.