NPIMap

Organization Active NPI

Northeast Alabama Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Scottsboro, AL
National Provider Identifier
1659448983
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTHEAST ALABAMA HEALTH SERVICES, INC
Practice address
309 Taylor St
Scottsboro, AL 35768-2421
Phone
(256) 256-5313
Fax
(256) 259-4923
NPI assigned
Nov 30, 2006
Last updated
May 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Authorized official

Name
James P Allen Jr.
Title
Ceo
Phone
(256) 259-5313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

309 Taylor St
Scottsboro, AL 35768-2421

Mailing address

309 Taylor St
Scottsboro, AL 35768-2421
Phone (256) 259-5313

Other identifiers 2

IdentifierTypeStateIssuer
630399999MedicaidAL
630000003MedicaidAL

Other names 1

  • JACKSON COUNTY RURAL HEALTH PROJECT Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000485 AL Part B Supplier - Clinic/Group Practice 4082522883 Receives reassigned benefits from 17 practitioners
2 other NPIs on this enrollment
Practice locations: Bryant, AL; Fort Payne, AL; Fyffe, AL; Scottsboro, AL; Section, AL; Woodville, AL

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

3840 Gault Ave N
Fort Payne, AL 35967
Phone (256) 844-4975

Ownership & related parties

Subparts reporting this organization as parent 7

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1659448983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 TAYLOR ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682421",
            "telephone_number": "256-259-5313",
            "fax_number": "256-259-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 TAYLOR ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682421",
            "telephone_number": "256-256-5313",
            "fax_number": "256-259-4923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ALABAMA HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-259-5313",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630399999",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000003",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKSON COUNTY RURAL HEALTH PROJECT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scottsboro, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.