Organization Active NPI

Fitz-Gerald & Perret Clinic

  • Family Medicine Physician
  • Demopolis, AL
National Provider Identifier
1750347142
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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 Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
529302040MedicaidAL

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.

Verify at the official NPI Registry.