NPIMap

Organization Active NPI

Southern Medical Holdings, LLC

  • Primary Care Clinic/Center
  • Rainbow City, AL
National Provider Identifier
1881073294
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
DO639 Issued in AL
Legal business name
SOUTHERN MEDICAL HOLDINGS, LLC
Practice address
190 Independent Dr Ste a
Rainbow City, AL 35906-3286
Phone
(256) 442-1834
Fax
(877) 991-4819
NPI assigned
May 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Authorized official

Name
John Mattox Raines, D.O.NPI 1679587737
Title
Owner
Phone
(256) 442-1834

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
Primary Care Clinic/Center 261QP2300X DO639 AL Primary

Addresses

Primary practice location

190 Independent Dr Ste a
Rainbow City, AL 35906-3286

Mailing address

190 Independent Dr Ste a
Rainbow City, AL 35906-3286
Phone (256) 442-1834

Other names 1

  • Raines Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151112002145 AL Part B Supplier - Clinic/Group Practice 1951611417 Receives reassigned benefits from 3 practitioners
Practice locations: Rainbow City, AL

National Provider Directory

National Provider Directory

Locations

3731 Rainbow Dr
Ste B
Rainbow City, AL 35906
Phone (256) 442-1834

190 Independent Dr
Ste A
Rainbow City, AL 35906
Phone (256) 442-1834

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1881073294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 INDEPENDENT DR STE A",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359063286",
            "telephone_number": "256-442-1834",
            "fax_number": "877-991-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 INDEPENDENT DR STE A",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359063286",
            "telephone_number": "256-442-1834",
            "fax_number": "877-991-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "RAINES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MATTOX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-442-1834",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AL",
            "license": "DO639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Raines Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Raines Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rainbow City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.