Canebrake Medical Management

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11061 Issued in AL

Legal business name

CANEBRAKE MEDICAL MANAGEMENT

Practice address

123 E Capitol St
Demopolis, AL 36732-2218

Phone

(334) 289-9408

NPI assigned

May 10, 2011

Last updated

Oct 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Terre M. Moore, CRNP

Title

CRNP

Phone

(334) 289-9408

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Cinnamon Travis Cramer, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Demopolis, AL
  • NPI 1639276702
  NPD (past)

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1821380866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E CAPITOL ST",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367322218",
            "telephone_number": "334-289-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E CAPITOL ST",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367322218",
            "telephone_number": "334-289-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANEBRAKE MEDICAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "TERRE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CRNP",
        "authorized_official_telephone_number": "334-289-9408",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "11061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129958",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Webb Breckenridge
• Bruno's Supermarkets, LLC. (Food World Pharmacy #138)
• Bryan Whitfield Mem Hosp Amb
• Rebecca Moore Bumgarner, PHARMD
• Emily Gray Bush, PHARMD
• Canebrake Speech Therapy, LLC
• Madison Duckworth Cannon, MD
• Michael Cappelli, M.D.
• Capstone Health Services Foundation PC (University Medical Center Demopolis)
• Deborah Ann Carlisle, CRNP

• Family Medicine Physician in Demopolis, AL
• Providers in Demopolis, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.