NPIMap

Monroe County Health Care Authority

Organization Active NPI Family Medicine Physician · Monroeville, AL

NPI 1871015461 · NPPES record last updated Jul 14, 2017

Key facts

NPI
1871015461
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
MONROE COUNTY HEALTH CARE AUTHORITY
Practice address
2016 S Alabama Ave Ste C
Monroeville, AL 36460-3044
Phone
(251) 575-3111
Fax
(251) 743-7445
NPI assigned
Jul 14, 2017
Organization subpart
Yes
Parent organization (as reported)
MONROE COUNTY HOSPITAL BOARD

Authorized official

Name
Kathy Johnson
Title
PFS Director
Phone
(251) 743-7485

Other NPIs on the same Medicare enrollment 2

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

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160321001799 AL Part B Supplier - Clinic/Group Practice 2668365859 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monroeville, AL

National Provider Directory

Tax ID family
MCH Surge3Ry Clinic (9 organizations share this tax ID)
Part of
MCH Surge3Ry Clinic

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207V00000X

Addresses

Primary practice location

2016 S Alabama Ave Ste C
Monroeville, AL 36460-3044

Mailing address

PO Box 886
Monroeville, AL 36461-0886
Phone (251) 575-3111

Other names

  • MCH Physicians Group Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 14, 2017.

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499990400000",
    "number": "1871015461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 886",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "364610886",
            "telephone_number": "251-575-3111",
            "fax_number": "251-743-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S ALABAMA AVE STE C",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "364603044",
            "telephone_number": "251-575-3111",
            "fax_number": "251-743-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE COUNTY HEALTH CARE AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONROE COUNTY HOSPITAL BOARD",
        "enumeration_date": "2017-07-14",
        "last_updated": "2017-07-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "PFS DIRECTOR",
        "authorized_official_telephone_number": "251-743-7485"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCH Physicians Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCH Physicians Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroeville, AL

All providers in Monroeville, AL · Family Medicine Physician in Alabama

Sources for this page

Verify at the official NPI Registry.