NPIMap

Organization Active NPI

Alice M Kidd Nursing Facility

  • Nursing Facility/Intermediate Care Facility
  • Tuscaloosa, AL
National Provider Identifier
1790855211
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
ALICE M KIDD NURSING FACILITY
Practice address
200 University Blvd
Tuscaloosa, AL 35402-0707
Phone
(205) 759-0633
Fax
(205) 759-0133
NPI assigned
Nov 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Nedra Moncrief-Craig, FACILITY DIRECTOR
Title
Facility Director
Phone
(205) 759-0633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X Primary

Addresses

Primary practice location

200 University Blvd
Tuscaloosa, AL 35402-0707

Mailing address

PO Box 20707
200 University Blvd
Tuscaloosa, AL 35402-0707
Phone (205) 759-0633

Other identifiers 1

IdentifierTypeStateIssuer
47577705MedicaidAL

National Provider Directory

National Provider Directory
Tax ID family
Samual Gaskins MD45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790855211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20707",
            "address_2": "200 UNIVERSITY BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354020707",
            "telephone_number": "205-759-0633",
            "fax_number": "205-759-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354020707",
            "telephone_number": "205-759-0633",
            "fax_number": "205-759-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICE M KIDD NURSING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONCRIEF-CRAIG",
        "authorized_official_first_name": "NEDRA",
        "authorized_official_title_or_position": "FACILITY DIRECTOR",
        "authorized_official_telephone_number": "205-759-0633",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FACILITY DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47577705",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.