NPIMap

Individual provider Active NPI

Jeremy Keon Prince, DO

  • Family Medicine Physician
  • Athens, AL
National Provider Identifier
1629692769
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO.3309 Issued in AL
Practice address
15243 Greenfield Dr Ste a
Athens, AL 35613-2899
Phone
(256) 262-5700
Fax
(256) 262-5710
NPI assigned
Jun 4, 2020
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PRIN-CYGCZT MS
Family Medicine Physician 207Q00000X DO.3309 AL Primary

Addresses

Primary practice location

15243 Greenfield Dr Ste a
Athens, AL 35613-2899

Mailing address

533 MLK Rd
Aliceville, AL 35442
Phone (256) 225-1339

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
I20231013000391 AL Practitioner - Family Practice 4587089867 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Limestone Medical AssociatesGroup PAC ID 7012378219, 6 clinicians

Practice addresses (Care Compare)

15243 Greenfield Dr
Suite a
Athens, AL 35613-2899
Phone (256) 262-5700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.3309ALMDFamily Medicine Physician
PRIN-CYGCZTMSMDFamily Medicine Physician
3309ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Limestone Medical Associates Family Medicine CurrentSince Aug 28, 2023 Accepting new patients
Alignmed Medical Group, PC CurrentSince Aug 24, 2024 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Jul 1, 2024 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Jul 1, 2024 Accepting new patients
Alabama Mso LLC Family Medicine CurrentSince Oct 4, 2025 Accepting new patients
Alignmed Partners, PC CurrentSince Jun 1, 2024 Accepting new patients
Whitesburg SNF Operations LLC Past Accepting new patients
Sunbridge Healthcare LLC Past Accepting new patients

Locations

15243 Greenfield Dr
#A
Athens, AL 35613
Phone (256) 233-2332

401 Arnold St NE
Cullman, AL 35055
Phone (256) 739-9593

1350 14th Ave SE
Decatur, AL 35601
Phone (256) 355-6911

420 Dean Dr
Gardendale, AL 35071
Phone (205) 631-8700

500 John Aldridge Dr
Tuscumbia, AL 35674
Phone (256) 373-4541

Organizations & group practices 8

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

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1629692769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 MLK RD",
            "city": "ALICEVILLE",
            "state": "AL",
            "postal_code": "35442",
            "telephone_number": "256-225-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 GREENFIELD DR STE A",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356132899",
            "telephone_number": "256-262-5700",
            "fax_number": "256-262-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "JEREMY",
        "middle_name": "KEON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-04",
        "last_updated": "2024-07-01",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "PRIN-CYGCZT",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.3309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, AL

Sources for this page

Verify at the official NPI Registry.