NPIMap

Organization Active NPI

Prattville Christian Family Medicine

  • Family Medicine Physician
  • Prattville, AL
National Provider Identifier
1649696196
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00025985 Issued in AL
Legal business name
PRATTVILLE CHRISTIAN FAMILY MEDICINE
Practice address
478 McQueen Smith Rd S
Prattville, AL 36066-5631
Phone
(334) 356-9200
Fax
(334) 356-1064
NPI assigned
Mar 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Authorized official

Name
Ashley McIntyre, MD
Title
Owner
Phone
(334) 279-8180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 00025985 AL Primary

Addresses

Primary practice location

478 McQueen Smith Rd S
Prattville, AL 36066-5631

Mailing address

128 Mitylene Park LN
Montgomery, AL 36117-3758
Phone (334) 279-8180

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

S
478 McQueen Smith Rd
Prattville, AL 36066
Phone (334) 356-9200

478 McQueen Smith Rd S
Prattville, AL 36066
Phone (334) 356-9200

NPI Registry JSON

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1649696196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MITYLENE PARK LN",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173758",
            "telephone_number": "334-279-8180",
            "fax_number": "334-279-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 MCQUEEN SMITH RD S",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665631",
            "telephone_number": "334-356-9200",
            "fax_number": "334-356-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATTVILLE CHRISTIAN FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "MCINTYRE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-279-8180",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00025985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.