NPIMap

Organization Active NPI

Physicians Care of Clarke

  • Federally Qualified Health Center (FQHC)
  • Butler, AL
National Provider Identifier
1801502265
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PHYSICIANS CARE OF CLARKE
Practice address
315 E Pushmataha St
Butler, AL 36904-2533
Phone
(205) 278-4315
Fax
(205) 278-4348
NPI assigned
Jan 27, 2023
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Farrell A Turner
Title
Ceo
Phone
(256) 201-0095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

315 E Pushmataha St
Butler, AL 36904-2533

Mailing address

24B Camden Byp
Camden, AL 36726-1770
Phone (334) 882-1919

Other names 1

  • AKA PHYSICIANS CARE OF BUTLER Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210921001942 AL Part B Supplier - Clinic/Group Practice 2961809736 Receives reassigned benefits from 10 practitioners
6 other NPIs on this enrollment
Practice locations: Sweet Water, AL; Thomasville, AL; Grove Hill, AL; Fulton, AL; Camden, AL; Butler, AL
O20230531001463 AL Part A Provider - Federally Qualified Health Center (FQHC) 2961809736 Practice locations: Butler, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801502265. Details of each certification follow.

Federally qualified health center certification: CCN 011103

Legal name
PHYSICIANS CARE OF CLARKE
Doing business as
PHYSICIANS CARE OF BUTLER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 23, 2023
Last certification
Mar 23, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 20, 2018 in AL
Enrollment address
315 E Pushmataha St
Butler, AL 36904-2533

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2275482Physicians Care of Butler315 E Pushmataha St, Butler, AL 36904Certificate of waiverJan 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Aka Fulton Family Medical5 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

127 Clark St
Ste C
Grove Hill, AL 36451
Phone (251) 275-1274

31431 AL Highway 10
Sweet Water, AL 36782
Phone (334) 636-5311

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael Paul Norris Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Doris L Morris Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Ricky L Powell Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Shirley Robison Crowe Individual Corporate DirectorBoard Member Dec 19, 2022
Operational/Managerial ControlBoard Member Dec 19, 2022
William Robertson Phillippi Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Farrell a. Turner Individual Corporate OfficerCeo Apr 20, 2020
W-2 Managing EmployeeCeo Apr 20, 2020
Operational/Managerial ControlCeo Apr 20, 2020
Dwight Dwayne Figgers Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Larry Colston Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020
Steven Brent Megginson Individual Corporate DirectorBoard Member Apr 20, 2020
Operational/Managerial ControlBoard Member Apr 20, 2020

Practitioners & affiliated clinicians

Practitioners 12

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": "1674777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1801502265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24B CAMDEN BYP",
            "city": "CAMDEN",
            "state": "AL",
            "postal_code": "367261770",
            "telephone_number": "334-882-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E PUSHMATAHA ST",
            "city": "BUTLER",
            "state": "AL",
            "postal_code": "369042533",
            "telephone_number": "205-278-4315",
            "fax_number": "205-278-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CARE OF CLARKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "FARRELL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "256-201-0095"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AKA PHYSICIANS CARE OF BUTLER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Butler, AL

Sources for this page

Verify at the official NPI Registry.