NPIMap

Organization Active NPI

Corizon Healthcare

  • State or Local Public Health Clinic/Center
  • Elmore, AL
National Provider Identifier
1770020372
Registry record updated Jan 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
License
1-107743 Issued in AL
Legal business name
CORIZON HEALTHCARE
Practice address
2690 Marion Spillway Rd
Elmore, AL 36025-1531
Phone
(334) 567-2221
NPI assigned
Jan 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2017

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

Authorized official

Name
Anita Wilson, M.D.
Title
Physican
Phone
(334) 207-9988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X 1-107743 AL Primary

Addresses

Primary practice location

2690 Marion Spillway Rd
Elmore, AL 36025-1531

Mailing address

2690 Marion Spillway Rd
Elmore, AL 36025-1531
Phone (334) 567-2221

National Provider Directory

National Provider Directory
Tax ID family
Correctional Medical Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

2690 Marion Spillway Rd
Elmore, AL 36025
Phone (334) 567-1578

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484956800000",
    "number": "1770020372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 MARION SPILLWAY RD",
            "city": "ELMORE",
            "state": "AL",
            "postal_code": "360251531",
            "telephone_number": "334-567-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 MARION SPILLWAY RD",
            "city": "ELMORE",
            "state": "AL",
            "postal_code": "360251531",
            "telephone_number": "334-567-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORIZON HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-21",
        "last_updated": "2017-01-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "PHYSICAN",
        "authorized_official_telephone_number": "334-207-9988",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "AL",
            "license": "1-107743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmore, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2017; 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.