Organization Active NPI

Selma Doctors Clinic PC

  • Internal Medicine Physician
  • Selma, AL
National Provider Identifier
1891776050
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SELMA DOCTORS CLINIC PC
Practice address
509 Parkman Ave
Selma, AL 36701-5734
Phone
(334) 874-9064
Fax
(334) 874-2633
NPI assigned
Nov 7, 2005
Last updated
Jan 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Authorized official

Name
Alice Hinson
Title
Office Manager
Phone
(334) 874-9064

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Surgery Physician 208600000X

Addresses

Primary practice location

509 Parkman Ave
Selma, AL 36701-5734

Mailing address

509 Parkman Ave
P.O. Box 530
Selma, AL 36701-5734
Phone (334) 874-9064

Other identifiers 2

IdentifierTypeStateIssuer
CL0659OtherALRAILROAD MEDICARE
000060007MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040820001017 AL Part B Supplier - Clinic/Group Practice 4183698699 Receives reassigned benefits from 3 practitioners
Practice locations: Selma, AL

National Provider Directory

National Provider Directory
Tax ID family
Selma Doctors Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1891776050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 PARKMAN AVE",
            "address_2": "P.O. BOX 530",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367015734",
            "telephone_number": "334-874-9064",
            "fax_number": "334-874-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 PARKMAN AVE",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367015734",
            "telephone_number": "334-874-9064",
            "fax_number": "334-874-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELMA DOCTORS CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "HINSON",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-874-9064"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CL0659",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000060007",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; 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.