Organization Active NPI

Pmcoa, Inc.

Doing business as Health Star

  • Chiropractor
  • Montgomery, AL
National Provider Identifier
1861750267
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2338 Issued in AL
Legal business name
PMCOA, INC.
Doing business as
Health Star
Practice address
3283 Malcolm Dr
Montgomery, AL 36116-8816
Phone
(334) 491-1111
Fax
(334) 356-9873
NPI assigned
Apr 24, 2012
Last updated
Nov 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Authorized official

Name
Candice Warren Cobb, DCNPI 1619259108
Title
Owner
Phone
(334) 202-2680

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Chiropractor 111N00000X 2338 AL Primary

Addresses

Primary practice location

3283 Malcolm Dr
Montgomery, AL 36116-8816

Mailing address

PO Box 241467
Montgomery, AL 36124-1467
Phone (334) 356-1111

Other practice location 1

2441 Cobbs Ford Rd
Prattville, AL 36066-7763
Phone (334) 491-1111

Other names 1

  • Health Star Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.healthstarclinic.com Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180525002161 AL Part B Supplier - Clinic/Group Practice 5597929604 Receives reassigned benefits from 6 practitioners
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Locations

2441 Cobbs Ford Rd
Prattville, AL 36066
Phone (334) 491-1111

Practitioners & affiliated clinicians

Practitioners 6

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": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1861750267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241467",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361241467",
            "telephone_number": "334-356-1111",
            "fax_number": "334-356-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3283 MALCOLM DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361168816",
            "telephone_number": "334-491-1111",
            "fax_number": "334-356-9873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2441 Cobbs Ford Rd",
            "address_purpose": "LOCATION",
            "city": "Prattville",
            "state": "AL",
            "postal_code": "360667763",
            "country_code": "US",
            "telephone_number": "334-491-1111",
            "fax_number": "334-356-9873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PMCOA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-202-2680",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.healthstarclinic.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "website",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "3283 Malcolm Dr",
            "city": "Montgomery",
            "state": "AL",
            "country_code": "US",
            "postal_code": "361168816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Health Star",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.