Individual provider Active NPI

Ellen Frances McFadden, M. D.

  • Family Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1881640019
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10969 Issued in AL
Practice address
1100 Wellesley GRN
Tuscaloosa, AL 35406-3604
Phone
(205) 792-9485
NPI assigned
May 26, 2006
Last updated
Aug 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10969 AL Primary

Addresses

Primary practice location

1100 Wellesley GRN
Tuscaloosa, AL 35406-3604

Mailing address

701 University Blvd E
Tuscaloosa, AL 35401-2086
Phone (205) 752-2501

Other identifiers 1

IdentifierTypeStateIssuer
630505099MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060831000272 AL Practitioner - Internal Medicine 8022012277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10969ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medcenter Demopolis, LLC Family Medicine CurrentSince Sep 23, 2015 Accepting new patients

Locations

705 US Highway 80 W
Demopolis, AL 36732
Phone (205) 333-1993

3909 McFarland Blvd
Northport, AL 35476
Phone (205) 330-1707

5005 Oscar Baxter Dr
Tuscaloosa, AL 35405
Phone (205) 333-4654

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1881640019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012086",
            "telephone_number": "205-752-2501",
            "fax_number": "205-759-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WELLESLEY GRN",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063604",
            "telephone_number": "205-792-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFADDEN",
        "first_name": "ELLEN",
        "middle_name": "FRANCES",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "10969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630505099",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.