NPIMap

Organization Active NPI

Montgomery AIDS Outreach, Inc.

Doing business as Copeland Care Clinic

  • Medical Specialty Clinic/Center
  • Montgomery, AL
National Provider Identifier
1689651408
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
L5111 TYPE R Issued in AL
Legal business name
MONTGOMERY AIDS OUTREACH, INC.
Doing business as
Copeland Care Clinic
Practice address
2900 McGehee Rd
Montgomery, AL 36111
Phone
(334) 280-3349
Fax
(334) 356-1426
NPI assigned
Dec 22, 2005
Last updated
Nov 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Authorized official

Name
Ms. Anne Jordan-Reynolds
Title
Executive Director
Phone
(334) 386-0853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X L5111 TYPE R AL Primary

Addresses

Primary practice location

2900 McGehee Rd
Montgomery, AL 36111

Mailing address

PO Box 11087
Montgomery, AL 36111-0087
Phone (334) 280-3349

Other identifiers 1

IdentifierTypeStateIssuer
529401770MedicaidAL

Other names 1

  • COPELAND CARE CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

1702 Catherine Ct
Ste 1A
Auburn, AL 36830
Phone (334) 501-1081

545 W Main St
Ste 402
Dothan, AL 36301
Phone (334) 281-1818

1432 Broad St
Selma, AL 36701
Phone (334) 872-6795

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1689651408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11087",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361110087",
            "telephone_number": "334-280-3349",
            "fax_number": "334-356-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MCGEHEE RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36111",
            "telephone_number": "334-280-3349",
            "fax_number": "334-356-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY AIDS OUTREACH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "JORDAN-REYNOLDS",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "334-386-0853",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AL",
            "license": "L5111 TYPE R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529401770",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COPELAND CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COPELAND CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.