NPIMap

Organization Active NPI

Acts Retirement-Life Communities, Inc.

Doing business as Primary Care Services at Magnolia Trace

  • Internal Medicine Physician
  • Huntsville, AL
National Provider Identifier
1700754348
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ACTS RETIREMENT-LIFE COMMUNITIES, INC.
Doing business as
Primary Care Services at Magnolia Trace
Practice address
1 Clubhouse Ave SW
Huntsville, AL 35802-5015
Phone
(256) 261-1600
Fax
(256) 883-1842
NPI assigned
Oct 27, 2025
Last updated
Oct 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Susan Ahern
Title
SVP, Cfo
Phone
(215) 661-8330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1 Clubhouse Ave SW
Huntsville, AL 35802-5015

Mailing address

420 Delaware Dr
Fort Washington, PA 19034-2711
Phone (267) 787-4226

Other names 1

  • Primary Care Services at Magnolia Trace Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251209004559 AL Part B Supplier - Clinic/Group Practice 1951212380 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spanish Fort, AL; Huntsville, AL

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Normandy Farms Estates47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Practitioners & affiliated clinicians

Practitioners 2

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": "1761523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1700754348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE DR",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342711",
            "telephone_number": "267-787-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CLUBHOUSE AVE SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358025015",
            "telephone_number": "256-261-1600",
            "fax_number": "256-883-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTS RETIREMENT-LIFE COMMUNITIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-26",
        "status": "A",
        "authorized_official_last_name": "AHERN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SVP, CFO",
        "authorized_official_telephone_number": "215-661-8330"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Services at Magnolia Trace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.