Organization Active NPI

Community Urgent Care of Madison, Inc

Doing business as Community Urgent Care of Madison

  • Family Medicine Physician
  • Madison, AL
National Provider Identifier
1700256252
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY URGENT CARE OF MADISON, INC
Doing business as
Community Urgent Care of Madison
Practice address
30694 Highway 72
Suite E
Madison, AL 35756
Phone
(256) 230-6130
NPI assigned
Sep 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Authorized official

Name
Mallory K Jones
Title
Office Manager
Phone
(256) 230-6130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X AL Primary

Addresses

Primary practice location

30694 Highway 72
Suite E
Madison, AL 35756

Mailing address

30694 US Highway 72 Ste E
Madison, AL 35756-3231
Phone (256) 230-6130

Other names 1

  • Community Urgent Care of Madison Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150302000290 AL Part B Supplier - Clinic/Group Practice 3375869837 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Madison, AL

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2106144Community Urgent Care of Madison Inc30694 Highway 72 Suite E, Madison, AL 35756Certificate of waiverDec 10, 2027

National Provider Directory

National Provider Directory

Locations

3477 Lowery Pkwy
Ste 137
Fultondale, AL 35068
Phone (205) 379-6040

30694 US Highway 72
Ste E
Madison, AL 35756
Phone (256) 230-6130

30694 US Highway 72
Madison, AL 35756
Phone (256) 230-6130

Practitioners & affiliated clinicians

Practitioners 1

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": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1700256252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30694 US HIGHWAY 72 STE E",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357563231",
            "telephone_number": "256-230-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30694 HIGHWAY 72",
            "address_2": "SUITE E",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "35756",
            "telephone_number": "256-230-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY URGENT CARE OF MADISON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "256-230-6130"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Urgent Care of Madison",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Urgent Care of Madison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.