Individual provider Active NPI

Vickie Ivey Childs, CRNP

  • Family Nurse Practitioner
  • Troy, AL
National Provider Identifier
1659946655
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-126761 Issued in AL
Practice address
801 S Franklin Dr
Troy, AL 36081-3838
Phone
(334) 566-9800
NPI assigned
May 21, 2021
Last updated
May 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1-126761 AL Primary

Addresses

Primary practice location

801 S Franklin Dr
Troy, AL 36081-3838

Mailing address

401 McPherson Dr
Troy, AL 36079-8138
Phone (334) 465-5236

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
I20210715000142 AL Practitioner - Nurse Practitioner 9739581620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Health Associates LLCGroup PAC ID 3476570912, 11 clinicians

Practice addresses (Care Compare)

801 S Franklin Dr
Troy, AL 36081-3838
Phone (334) 566-9800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-126761ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Health Associates LLC Single Specialty CurrentSince Jul 1, 2021 Accepting new patients

Locations

801 S Franklin Dr
Troy, AL 36081
Phone (334) 566-9800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19802/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 1

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": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1659946655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MCPHERSON DR",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360798138",
            "telephone_number": "334-465-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S FRANKLIN DR",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360813838",
            "telephone_number": "334-566-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "VICKIE",
        "middle_name": "IVEY",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-126761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, AL

Sources for this page

Verify at the official NPI Registry.