NPIMap

Organization Active NPI

Escambia County Alabama Community Hospitals, Inc

Doing business as ACH Complete Care

  • Family Medicine Physician
  • Atmore, AL
National Provider Identifier
1740895200
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC
Doing business as
ACH Complete Care
Practice address
609 E. Laurel Street
Atmore, AL 36502
Phone
(251) 368-6960
NPI assigned
Sep 11, 2020
Last updated
Sep 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Bradley Lowery
Title
Administrator
Phone
(251) 368-6362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

609 E. Laurel Street
Atmore, AL 36502

Mailing address

609 E. Laurel Street
Atmore, AL 36502

Other names 1

  • ACH Complete Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040811000712 AL Part B Supplier - Clinic/Group Practice 4385616119 Receives reassigned benefits from 19 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atmore, AL
O20220614001377 AL Part A Provider - Rural Health Clinic 4385616119 Practice locations: Atmore, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740895200. Details of each certification follow.

Rural health clinic certification: CCN 018500

Legal name
ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC
Doing business as
ACH COMPLETE CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 19, 2023
Last certification
Jan 19, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 5, 2001 in AL
Enrollment address
609 E Laurel St
Atmore, AL 36502-3014
Related CCNs
010169

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

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

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
01D2225967Ach Complete Care609 East Laurel Street, Atmore, AL 36502Certificate of waiverMay 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Escambia Cnty Al Comm Hos9 organizations share this tax ID, including this one
Part of
Escambia Cnty Al Comm Hos

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Escambia County Alabama Community Hospitals, Inc Organization, Atmore, AL Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Layla Renee Lundquist-Smith Individual Corporate DirectorMedical Director Dec 2, 2020
Judith King Individual Corporate DirectorClinic Director, LPN Sep 10, 2007
W-2 Managing EmployeeClinic Director, LPN Sep 10, 2007
Bradley Lowery Individual Corporate DirectorAdministrator Dec 1, 2019
W-2 Managing EmployeeAdministrator Dec 1, 2019

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ach Family PhysiciansAtmore, AL, CCN 013444 Rural health clinic Operational/Managerial Control Sep 1, 2019
Ach Primary CareAtmore, AL, CCN 013445 Rural health clinic Operational/Managerial Control Sep 1, 2019
Atmore Urgent CareAtmore, AL, CCN 013446 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

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": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1740895200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 E. LAUREL STREET",
            "city": "ATMORE",
            "state": "AL",
            "postal_code": "36502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 E. LAUREL STREET",
            "city": "ATMORE",
            "state": "AL",
            "postal_code": "36502",
            "telephone_number": "251-368-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC",
        "enumeration_date": "2020-09-11",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "LOWERY",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "251-368-6362"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACH Complete Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ACH Complete Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atmore, AL

Sources for this page

Verify at the official NPI Registry.