Cherokee Family Healthcare, LLC
Organization Active NPI Primary Care Clinic/Center · Centre, AL
NPI 1750008801 · NPPES record last updated Oct 19, 2022
Key facts
- NPI
- 1750008801
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- CHEROKEE FAMILY HEALTHCARE, LLC
- Practice address
- 819 W Main St
Centre, AL 35960-1235 - Phone
- (256) 630-5467
- NPI assigned
- Oct 19, 2022
- Organization subpart
- No
Authorized official
- Name
- Connie L Geimer, CRNP
- Title
- Owner
- Phone
- (256) 630-5467
Owners & managing parties with NPI records 1
-
Connie Leigh Geimer, ACNP
Practitioners 4
-
Connie Leigh Geimer, ACNP
-
Piper Pearce, MSN, APRN, CRNP-C
-
William Barton Perry, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2271639 | Cherokee Family Healthcare | Certificate of waiver | Nov 3, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AL
Rural health clinic certification: CCN 018977
- Legal name
- CHEROKEE FAMILY HEALTHCARE LLC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Aug 13, 2024
- Last certification
- Aug 13, 2024
- Ownership / control type
- 1B
- Organization structure
- LLC · Proprietary
- Enrollment address
- 819 W Main St
Ste a
Centre, AL 35960-1235
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Connie L Geimer |
5% Or Greater Direct Ownership Interest | Nov 1, 2022 | 100% |
| Corporate Officer |
Nov 1, 2022 | 100% | |
| W-2 Managing Employee |
Nov 1, 2022 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230119000488 | AL | Part B Supplier - Clinic/Group Practice | 6800267444 |
Receives reassigned benefits from 4 practitioners Practice locations: Centre, AL |
| O20240321002805 | AL | Part a Provider - Rural Health Clinic | 6800267444 | Practice locations: Centre, AL |
National Provider Directory
Locations
819 W Main St
Centre, AL 35960
Phone (256) 266-1021
819 W Main St
#A
Centre, AL 35960
Phone (256) 266-1021
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BIDJCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
819 W Main St
Centre, AL 35960-1235
Mailing address
PO Box 610
Centre, AL 35960-0610
Phone (256) 630-5467
Other providers in Centre, AL
- Cherokee County Health Dept VFC Immun
- Cherokee County Physicians, LLC
- Cherokee Emergency Medical Services Inc
- Cherokee Eye Clinic Co, Inc
- Cherokee Eye Clinic, P.C.
- Cherokee Pain Management LLC
- Cherokee Pain Management, LLC
- Clinical Urology Associates, P.C.
- Heather Elise Combs
- April Hellums Connell
All providers in Centre, AL · Primary Care Clinic/Center in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.