NPIMap

Organization Active NPI

Keystone Medical Services of Alabama, Inc.

  • Emergency Medicine Physician
  • Troy, AL
National Provider Identifier
1790432243
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
KEYSTONE MEDICAL SERVICES OF ALABAMA, INC.
Practice address
1330 Highway 231 S
Troy, AL 36081-3058
Phone
(334) 670-5000
NPI assigned
Mar 4, 2022
Last updated
Mar 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Authorized official

Name
Glenn Adams
Title
President
Phone
(901) 795-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1330 Highway 231 S
Troy, AL 36081-3058

Mailing address

6075 Poplar Ave Ste 401
Memphis, TN 38119-0114
Phone (901) 795-3600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220609001921 AL Part B Supplier - Clinic/Group Practice 7719365352 Receives reassigned benefits from 61 practitioners
Practice locations: Luverne, AL; Troy, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 61

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 61

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1790432243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 POPLAR AVE STE 401",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190114",
            "telephone_number": "901-795-3600",
            "fax_number": "901-795-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 HIGHWAY 231 S",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360813058",
            "telephone_number": "334-670-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE MEDICAL SERVICES OF ALABAMA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-795-3600"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.