Southern Rural Health Care Consortium, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SOUTHERN RURAL HEALTH CARE CONSORTIUM, INC.

Practice address

318 Coffee Avenue
Russellville, AL 35653

Phone

(256) 332-1631

Fax

(256) 332-4600

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kathy L Hall

Title

Executive Director

Phone

(256) 332-1361

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Russellville Family Practice Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1750457941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356530970",
            "telephone_number": "256-332-1631",
            "fax_number": "256-332-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 COFFEE AVENUE",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "35653",
            "telephone_number": "256-332-1631",
            "fax_number": "256-332-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN RURAL HEALTH CARE CONSORTIUM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "256-332-1361",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE #",
            "identifier": "01-1907",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630007001",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russellville Family Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Keyna Nicole Smith, COTA
• Danny Ray Smitherman
• Southern Rural Health Care Consortium
• Southern Rural Health Care Consortium
• Southern Rural Health Care Consortium
• Southerncare Inc
• Jamie Springer
• Anna Spurgeon, LPTA
• SRD Russellville PLLC
• Erin Fae Stanley, DMD

• Federally Qualified Health Center (FQHC) in Russellville, AL
• Providers in Russellville, AL by specialty
• Federally Qualified Health Center (FQHC) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.