NPIMap

Organization Active NPI

Ivy Creek Specialty Care

  • Emergency Medical Services (Emergency Medicine) Physician
  • Dadeville, AL
National Provider Identifier
1750980819
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
IVY CREEK SPECIALTY CARE
Practice address
201 Mariarden Rd
Dadeville, AL 36853-6244
Phone
(256) 825-7821
NPI assigned
Oct 20, 2020
Last updated
Oct 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Teresa H Langford
Title
Credentialing Manager
Phone
(334) 283-2542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X Primary

Addresses

Primary practice location

201 Mariarden Rd
Dadeville, AL 36853-6244

Mailing address

201 Mariarden Rd
Dadeville, AL 36853-6244
Phone (256) 825-7821

Other names 1

  • LMCH LOCATION Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL DIRECT

National Provider Directory

National Provider Directory
Tax ID family
Ivy Creek Anesthesia3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1750980819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MARIARDEN RD",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368536244",
            "telephone_number": "256-825-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MARIARDEN RD",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368536244",
            "telephone_number": "256-825-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY CREEK SPECIALTY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "LANGFORD",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "334-283-2542"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "DIRECT",
            "affiliation": "N",
            "address_1": "201 Mariarden Rd",
            "city": "Dadeville",
            "state": "AL",
            "country_code": "US",
            "postal_code": "368536244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "LMCH LOCATION",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dadeville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.