Family Health Clinic of Union Springs, Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

FAMILY HEALTH CLINIC OF UNION SPRINGS, INC.

Practice address

309 Prairie St North
Union Springs, AL 36089-1418

Phone

(334) 782-8824

Fax

(334) 408-4681

NPI assigned

May 18, 2007

Organization subpart

No

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

Authorized official

Name

Carol McMillan Holder, CRNP

Title

President/ Administrator

Phone

(334) 473-8795

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Rural health clinic certification: CCN 013959

Legal name

FAMILY HEALTH CLINIC OF UNION SPRINGS, INC.

Certification status

Terminated Voluntary: merger or closure, Oct 31, 2025

Provider type (POS)

Rural health clinic

Participating since

Jun 8, 2011

Last certification

Oct 25, 2017

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Jun 12, 2007 in AL

Enrollment address

309 Prairie St N
Union Springs, AL 36089-1418

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Carol McMillan Holder, CRNP

  • Nurse Practitioner
  • Union Springs, AL
  • NPI 1184803066

  5% Or Greater Direct Ownership Interest, Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 1

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

• Maria Lourdes Bernardo, M.D.

  • Specialist
  • Troy, AL
  • NPI 1487762043
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1871701482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 PRAIRIE ST NORTH",
            "city": "UNION SPRINGS",
            "state": "AL",
            "postal_code": "360891418",
            "telephone_number": "334-738-2146",
            "fax_number": "334-408-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 PRAIRIE ST NORTH",
            "city": "UNION SPRINGS",
            "state": "AL",
            "postal_code": "360891418",
            "telephone_number": "334-782-8824",
            "fax_number": "334-408-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CLINIC OF UNION SPRINGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "MCMILLAN",
        "authorized_official_title_or_position": "PRESIDENT/ ADMINISTRATOR",
        "authorized_official_telephone_number": "334-473-8795",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "26270",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-031812",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138855",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529932739",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Union Springs, AL
• Rural Health Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.