NPIMap

Organization Active NPI

Fultondale Urgent Care Centers, LLC

  • General Practice Physician
  • Fultondale, AL
National Provider Identifier
1659697696
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FULTONDALE URGENT CARE CENTERS, LLC
Practice address
339 Walker Chapel Plaza
Suite 115
Fultondale, AL 35068
Phone
(205) 841-2844
Fax
(205) 380-7579
NPI assigned
Apr 15, 2010
Organization subpart
No

Practitioners 1

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

National Provider Directory

National Provider Directory

Member of 1

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

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Mr. Kenneth C. Randall
Title
Chief Administrative Officer
Phone
(205) 310-3902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

339 Walker Chapel Plaza
Suite 115
Fultondale, AL 35068

Mailing address

339 Walker Chapel Plaza
Suite 115
Fultondale, AL 35068
Phone (205) 841-2844

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1659697696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 WALKER CHAPEL PLAZA",
            "address_2": "SUITE 115",
            "city": "FULTONDALE",
            "state": "AL",
            "postal_code": "35068",
            "telephone_number": "205-841-2844",
            "fax_number": "205-380-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 WALKER CHAPEL PLAZA",
            "address_2": "SUITE 115",
            "city": "FULTONDALE",
            "state": "AL",
            "postal_code": "35068",
            "telephone_number": "205-841-2844",
            "fax_number": "205-380-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULTONDALE URGENT CARE CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-15",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "205-310-3902",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fultondale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.