NPIMap

Organization Active NPI

Center Star Family Practice, Inc

  • Family Medicine Physician
  • Killen, AL
National Provider Identifier
1801950167
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1035809 Issued in AL
Legal business name
CENTER STAR FAMILY PRACTICE, INC
Practice address
6459 Highway 72
Killen, AL 35645-8258
Phone
(256) 272-0275
Fax
(256) 272-0277
NPI assigned
Dec 21, 2006
Last updated
Feb 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Authorized official

Name
Debra P. Dinges, C.R.N.PNPI 1740227016
Title
Owner
Phone
(256) 272-0275

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1035809 AL Primary

Addresses

Primary practice location

6459 Highway 72
Killen, AL 35645-8258

Mailing address

PO Box 70
Killen, AL 35645-0070
Phone (256) 272-0275

Other identifiers 1

IdentifierTypeStateIssuer
529919990MedicaidAL

National Provider Directory

National Provider Directory

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": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1801950167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "KILLEN",
            "state": "AL",
            "postal_code": "356450070",
            "telephone_number": "256-272-0275",
            "fax_number": "256-272-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6459 HIGHWAY 72",
            "city": "KILLEN",
            "state": "AL",
            "postal_code": "356458258",
            "telephone_number": "256-272-0275",
            "fax_number": "256-272-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER STAR FAMILY PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "DINGES",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-272-0275",
        "authorized_official_credential": "C.R.N.P"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "1035809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529919990",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Killen, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; 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.