NPIMap

Organization Active NPI

Chatom Primary Care PC

  • Rural Health Clinic/Center
  • Chatom, AL
National Provider Identifier
1730158544
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CHATOM PRIMARY CARE PC
Practice address
14634 Saint Stephens Ave
Chatom, AL 36518-6711
Phone
(251) 847-6262
Fax
(251) 847-6277
NPI assigned
Mar 15, 2006
Last updated
Apr 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
James Steven Donald, MDNPI 1558339234
Title
Owner President
Phone
(251) 847-6266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

14634 Saint Stephens Ave
Chatom, AL 36518-6711

Mailing address

PO Box 1237
Chatom, AL 36518-1237
Phone (251) 847-6266

Other identifiers 2

IdentifierTypeStateIssuer
541003923MedicaidAL
529905180MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051109001188 AL Part B Supplier - Clinic/Group Practice 9537187380 Receives reassigned benefits from 8 practitioners
Practice locations: Chatom, AL
O20101202001023 AL Part A Provider - Rural Health Clinic 9537187380 Practice locations: Chatom, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730158544. Details of each certification follow.

Rural health clinic certification: CCN 013923

Legal name
CHATOM PRIMARY CARE PC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 5, 2002
Last certification
May 28, 2025
Ownership / control type
1B
Organization structure
CorporationProprietary
Enrollment address
14634 Saint Stephens Ave
Chatom, AL 36518-6711

National Provider Directory

National Provider Directory
Tax ID family
Chatom Primary Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

14634 Saint Stephens Ave
Chatom, AL 36518
Phone (251) 847-3077

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robyn R Reynolds Individual W-2 Managing EmployeeAd; Mar 5, 2002
James S Donald Individual 5% Or Greater Direct Ownership InterestPresident Mar 5, 2002 100%
W-2 Managing EmployeeOwner Mar 5, 2002 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 10

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": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1730158544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1237",
            "city": "CHATOM",
            "state": "AL",
            "postal_code": "365181237",
            "telephone_number": "251-847-6266",
            "fax_number": "251-847-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14634 SAINT STEPHENS AVE",
            "city": "CHATOM",
            "state": "AL",
            "postal_code": "365186711",
            "telephone_number": "251-847-6262",
            "fax_number": "251-847-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATOM PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "DONALD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "251-847-6266",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "541003923",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529905180",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatom, AL

Sources for this page

Verify at the official NPI Registry.