Organization Active NPI

Vernon Medical Center

  • Family Medicine Physician
  • Vernon, AL
National Provider Identifier
1841950052
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VERNON MEDICAL CENTER
Practice address
44946 Highway 17
Vernon, AL 35592-5630
Phone
(205) 557-1300
NPI assigned
Dec 29, 2021
Last updated
Dec 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Authorized official

Name
Amber D Pennington, NPNPI 1649692922
Title
Owner
Phone
(205) 712-5387

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

44946 Highway 17
Vernon, AL 35592-5630

Mailing address

44946 Highway 17
Vernon, AL 35592-5630
Phone (205) 557-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220112002404 AL Part B Supplier - Clinic/Group Practice 2163814658 Receives reassigned benefits from 1 practitioner
Practice locations: Vernon, AL

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
01D2165064Vernon Medical Center44946 Highway 17, Vernon, AL 35592Certificate of waiverApr 17, 2027

National Provider Directory

National Provider Directory

Locations

44946 Highway 17
Vernon, AL 35592
Phone (205) 557-1300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25441/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1841950052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44946 HIGHWAY 17",
            "city": "VERNON",
            "state": "AL",
            "postal_code": "355925630",
            "telephone_number": "205-557-1300",
            "fax_number": "205-557-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44946 HIGHWAY 17",
            "city": "VERNON",
            "state": "AL",
            "postal_code": "355925630",
            "telephone_number": "205-557-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "PENNINGTON",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-712-5387",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.