Active NPI
Fitz-Gerald & Perret Clinic
- Family Medicine Physician
- Demopolis, AL
National Provider Identifier
1750347142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FITZ-GERALD & PERRET CLINIC
- Practice address
- 203 Hwy 80 West
Demopolis, AL 36732 - Phone
- (334) 289-1517
- Fax
- (334) 289-8353
- NPI assigned
- Apr 25, 2006
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Mr. Mack Fitz-Gerald
- Title
- Administrator
- Phone
- (334) 289-1517
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
National Provider Directory
National Provider DirectorySpecialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
203 Hwy 80 West
Demopolis, AL 36732
Mailing address
203 Hwy 80 West
P. O. Box 935
Demopolis, AL 36732
Phone (334) 289-1517
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 529302040 | Medicaid | AL |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 7, 2011.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1299456000000",
"number": "1750347142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 HWY 80 WEST",
"address_2": "P. O. BOX 935",
"city": "DEMOPOLIS",
"state": "AL",
"postal_code": "36732",
"telephone_number": "334-289-1517",
"fax_number": "334-289-8353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 HWY 80 WEST",
"city": "DEMOPOLIS",
"state": "AL",
"postal_code": "36732",
"telephone_number": "334-289-1517",
"fax_number": "334-289-8353"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FITZ-GERALD & PERRET CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-25",
"last_updated": "2011-03-07",
"status": "A",
"authorized_official_last_name": "FITZ-GERALD",
"authorized_official_first_name": "MACK",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "334-289-1517",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "529302040",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Demopolis, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.