NPIMap

Organization Active NPI

American Family Care, LLC

Doing business as American Family Care

  • General Practice Physician
  • Enterprise, AL
National Provider Identifier
1720459134
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
AMERICAN FAMILY CARE, LLC
Doing business as
American Family Care
Practice address
606 Boll Weevil Cir
A
Enterprise, AL 36330-2734
Phone
(334) 475-2462
Fax
(334) 475-2466
NPI assigned
Oct 12, 2015
Last updated
Apr 24, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERICAN FAMILY CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
Randy Johansen
Title
President
Phone
(205) 403-8902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

606 Boll Weevil Cir
A
Enterprise, AL 36330-2734

Mailing address

3700 Cahaba Beach Rd
Birmingham, AL 35242-5225
Phone (205) 403-8902

Other identifiers 1

IdentifierTypeStateIssuer
C417OtherALMEDICARE PTAN#

Other names 1

  • American Family Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031229000157 AL Part B Supplier - Clinic/Group Practice 9739087818 Receives reassigned benefits from 704 practitioners
This NPI is an additional NPI on the enrollment

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
01D2102098American Family Care - Enterprise606 Boll Weevil Circle, Suite a, Enterprise, AL 36330Certificate of waiverAug 29, 2026

National Provider Directory

National Provider Directory
Tax ID family
Amer Famcare Med CT Montg31 organizations share this tax ID, including this one
Part of
Amer Famcare Med CT Montg

Other organizations with this tax ID 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1720459134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CAHABA BEACH RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425225",
            "telephone_number": "205-403-8902",
            "fax_number": "205-421-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 BOLL WEEVIL CIR",
            "address_2": "A",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302734",
            "telephone_number": "334-475-2462",
            "fax_number": "334-475-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN FAMILY CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN FAMILY CARE, LLC",
        "enumeration_date": "2015-10-12",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-403-8902"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN#",
            "identifier": "C417",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.