NPIMap

Organization Active NPI

The Health Care Authority of the City of Eufaula

Doing business as Lake Eufaula Primary Care

  • Primary Care Clinic/Center
  • Eufaula, AL
National Provider Identifier
1699288522
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
THE HEALTH CARE AUTHORITY OF THE CITY OF EUFAULA
Doing business as
Lake Eufaula Primary Care
Practice address
130 N Randolph Ave
Eufaula, AL 36027-1631
Phone
(334) 688-7451
NPI assigned
Nov 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Authorized official

Name
Ralph Clark
Title
Ceo
Phone
(334) 688-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

130 N Randolph Ave
Eufaula, AL 36027-1631

Mailing address

820 W Washington St
Eufaula, AL 36027-1822
Phone (334) 688-7000

Other names 1

  • Lake Eufaula Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180619000582 AL Part B Supplier - Clinic/Group Practice 9335407659 Receives reassigned benefits from 36 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eufaula, AL; Louisville, AL; Hurtsboro, AL

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Member of 1

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

Locations

7413 Whitesville Rd
Columbus, GA 31904
Phone (706) 442-4332

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510617600000",
    "number": "1699288522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W WASHINGTON ST",
            "city": "EUFAULA",
            "state": "AL",
            "postal_code": "360271822",
            "telephone_number": "334-688-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N RANDOLPH AVE",
            "city": "EUFAULA",
            "state": "AL",
            "postal_code": "360271631",
            "telephone_number": "334-688-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HEALTH CARE AUTHORITY OF THE CITY OF EUFAULA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-688-2000"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Eufaula Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eufaula, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; 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.