Individual provider Active NPI

Denise Michelle Adcock, CRNP

  • Family Nurse Practitioner
  • Rainbow City, AL
National Provider Identifier
1659848075
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-066157 Issued in AL
Practice address
170 Independent Dr
Rainbow City, AL 35906-3286
Phone
(256) 413-1467
Fax
(256) 413-1470
NPI assigned
Oct 24, 2018
Last updated
Oct 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-066157 AL Primary

Addresses

Primary practice location

170 Independent Dr
Rainbow City, AL 35906-3286

Mailing address

170 Independent Dr
Rainbow City, AL 35906-3286
Phone (256) 413-1467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210609002523 AL Practitioner - Nurse Practitioner 9931509148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Immediate Care, LLCGroup PAC ID 6103114087, 46 clinicians

Practice addresses (Care Compare)

4100 McClellan Blvd
Anniston, AL 36201-2132
Phone (256) 235-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-066157ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Immediate Care, LLC CurrentSince May 3, 2021 Accepting new patients
Keel and Associates CurrentSince May 3, 2021 Accepting new patients
Etowah Pediatrics Past Accepting new patients

Locations

4100 McClellan Blvd
Anniston, AL 36201
Phone (256) 235-2273

956 Gilbert Ferry Rd SE
Attalla, AL 35954
Phone (256) 344-0065

150 Tompkins St
Heflin, AL 36264
Phone (256) 463-2969

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17814/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1659848075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 INDEPENDENT DR",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359063286",
            "telephone_number": "256-413-1467",
            "fax_number": "256-413-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 INDEPENDENT DR",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359063286",
            "telephone_number": "256-413-1467",
            "fax_number": "256-413-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADCOCK",
        "first_name": "DENISE",
        "middle_name": "MICHELLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-066157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rainbow City, AL

Sources for this page

Verify at the official NPI Registry.