Ivy Creek of Butler, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

IVY CREEK OF BUTLER, LLC

Practice address

515 N Miranda Ave
Georgiana, AL 36033-4519

Phone

(334) 376-2205

Fax

(334) 376-3660

NPI assigned

May 2, 2013

Organization subpart

No

Name

Mr. Michael D Bruce

Title

Ceo

Phone

(334) 376-2963

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Rmcca Clinic a LLC

  • Clinic/Center
  • Greenville, AL
  • NPI 1477979672

  O20130603000397

  Same enrollment
• The Health Care Authority of the City of Greenville

  • Rural Health Clinic/Center
  • Georgiana, AL
  • NPI 1073958195

  O20130603000397

  Same enrollment

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

• Muhammad Zabed Akbar, MD

  • Family Medicine Physician
  • Georgiana, AL
  • NPI 1801994983
  NPD
• Amrita Yearwood, MD

  • Internal Medicine Physician
  • Evergreen, AL
  • NPI 1770559734
  NPD
• Johnstone Powe Hollis, MD

  • Family Medicine Physician
  • Centreville, AL
  • NPI 1619986924

  Emergency Medicine

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Tax ID family

Butler - Ivy Creek Home Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Butler - Ivy Creek Home Health, LLC

  • Home Health Agency
  • Georgiana, AL
  • NPI 1124161054
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 2, 2013.

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1629413745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N MIRANDA AVE",
            "city": "GEORGIANA",
            "state": "AL",
            "postal_code": "360334519",
            "telephone_number": "334-376-2205",
            "fax_number": "334-376-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N MIRANDA AVE",
            "city": "GEORGIANA",
            "state": "AL",
            "postal_code": "360334519",
            "telephone_number": "334-376-2205",
            "fax_number": "334-376-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY CREEK OF BUTLER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-376-2963",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgiana Medical Supply Inc
• Georgiana Pharmacy, LLC
• Brandon Hester, PHARMD
• Ashley Nicole Huggins, CRNP
• Ivy Creek of Butler LLC
• Ivy Creek-Butler Home Health LLC
• Owens Medical Supply LLC
• Nicole M Seale, CRNP
• Brittany Sheffield, CRNP
• South Butler Medical Services LLC

• All providers in Georgiana, AL
• Emergency Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.