Family Medical Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-072201 Issued in AL

Legal business name

FAMILY MEDICAL CLINIC LLC

Practice address

1355 George Wallace Hwy
Russellville, AL 35654-3281

Phone

(256) 331-9700

Fax

(256) 331-2615

NPI assigned

Jul 8, 2009

Last updated

Nov 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Potter

Title

Owner

Phone

(256) 331-9700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1710116066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 SAYLORS CV",
            "city": "TUSCUMBIA",
            "state": "AL",
            "postal_code": "356747700",
            "telephone_number": "256-331-9700",
            "fax_number": "256-331-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 GEORGE WALLACE HWY",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356543281",
            "telephone_number": "256-331-9700",
            "fax_number": "256-331-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-08",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-331-9700"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-072201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Everstead Health and Rehabilitation Center LLC
• Eyecare for Life, PC
• Eyecare Professionals, P.C.
• Eyedocs on Wheels PC
• Family Health Care Clinic, Inc.
• Family Medicine of Russellville Inc
• Family Pharmacy of Littleville Inc
• Family Pharmacy of Littleville Inc
• Franklin County Health Dept Adult Immun
• Franklin County Health Dept AIDS

• Family Nurse Practitioner in Russellville, AL
• Providers in Russellville, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.