Modern Health Family Care Practice

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MODERN HEALTH FAMILY CARE PRACTICE

Practice address

13000 Cottonwood Rd
Cottonwood, AL 36320-4280

Phone

(334) 797-4787

NPI assigned

May 1, 2020

Organization subpart

No

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

Authorized official

Name

Jessica Carliela Jones, CRNPNPI 1285156752

Title

Owner

Phone

(334) 797-4787

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Jessica Carliela Jones, CRNP

  • Family Nurse Practitioner
  • Dothan, AL
  • NPI 1285156752
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598486400000",
    "number": "1891316758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 509",
            "city": "COTTONWOOD",
            "state": "AL",
            "postal_code": "363200509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 COTTONWOOD RD",
            "city": "COTTONWOOD",
            "state": "AL",
            "postal_code": "363204280",
            "telephone_number": "334-797-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN HEALTH FAMILY CARE PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-01",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "CARLIELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-797-4787",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Cottonwood, AL
• Providers in Cottonwood, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.