NPIMap

Organization Active NPI

Fort Payne Hospital Corporation

  • General Acute Care Hospital
  • Fort Payne, AL
National Provider Identifier
1710901178
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
012866 Issued in AL
Legal business name
FORT PAYNE HOSPITAL CORPORATION
Practice address
200 Medical Center Dr SW
Fort Payne, AL 35968-3458
Phone
(256) 845-3150
Fax
(256) 997-2512
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Authorized official

Name
Randy Michael Cooper
Title
SVP Finance Operations/Ao
Phone
(615) 221-3840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 012866 AL Primary

Addresses

Primary practice location

200 Medical Center Dr SW
Fort Payne, AL 35968-3458

Mailing address

PO Box 277507
Atlanta, GA 30384-7507

Other identifiers 2

IdentifierTypeStateIssuer
010-109OtherBCBS
HOS0012HMedicaidAL

Other names 1

  • Dekalb Regional Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1710901178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277507",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683458",
            "telephone_number": "256-845-3150",
            "fax_number": "256-997-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT PAYNE HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SVP FINANCE OPERATIONS/AO",
        "authorized_official_telephone_number": "615-221-3840"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AL",
            "license": "012866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010-109",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0012H",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dekalb Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dekalb Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.