NPIMap

Organization Active NPI

Attentus Moulton, LLC

Doing business as Moulton Primary Care Clinic

  • Rural Health Clinic/Center
  • Moulton, AL
National Provider Identifier
1760930200
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ATTENTUS MOULTON, LLC
Doing business as
Moulton Primary Care Clinic
Practice address
40 Medical Cir
Moulton, AL 35650-1256
Phone
(256) 974-0606
Fax
(256) 522-2227
NPI assigned
Sep 13, 2016
Last updated
Jul 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Authorized official

Name
Christy Louallen
Title
Credentialing/Billing Supervisor
Phone
(256) 974-2207

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

40 Medical Cir
Moulton, AL 35650-1256

Mailing address

PO Box 340
Moulton, AL 35650-0340
Phone (256) 974-2207

Other names 1

  • Moulton Primary Care Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050517000324 AL Part B Supplier - Clinic/Group Practice 6406895382 Receives reassigned benefits from 33 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Courtland, AL; Moulton, AL

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

350 Tennessee St
Courtland, AL 35618
Phone (256) 637-8033

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
May 24, 2025 Change of OwnershipThis provider was the seller Moulton Primary Care ClinicCCN 013466, AL, NPI 1932991544

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1760930200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "MOULTON",
            "state": "AL",
            "postal_code": "356500340",
            "telephone_number": "256-974-2207",
            "fax_number": "256-974-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MEDICAL CIR",
            "city": "MOULTON",
            "state": "AL",
            "postal_code": "356501256",
            "telephone_number": "256-974-0606",
            "fax_number": "256-522-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATTENTUS MOULTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-13",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "LOUALLEN",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "CREDENTIALING/BILLING SUPERVISOR",
        "authorized_official_telephone_number": "256-974-2207"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moulton Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moulton Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moulton, AL

Sources for this page

Verify at the official NPI Registry.