Organization Active NPI

North Alabama Primary Care,PC

  • Internal Medicine Physician
  • Athens, AL
National Provider Identifier
1912118456
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTH ALABAMA PRIMARY CARE,PC
Practice address
1015 Highway 72 East
Suite 1
Athens, AL 35611
Phone
(256) 232-2505
Fax
(256) 230-3226
NPI assigned
May 25, 2007
Last updated
Mar 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Dr. Chandra S Koneru, MDNPI 1982758132
Title
Physician
Phone
(256) 232-2505

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
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1015 Highway 72 East
Suite 1
Athens, AL 35611

Mailing address

1015 Highway 72 East
Suite 1
Athens, AL 35611
Phone (256) 232-2505

Other identifiers 1

IdentifierTypeStateIssuer
CI3887OtherALRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051128000847 AL Part B Supplier - Clinic/Group Practice 8426078031 Receives reassigned benefits from 2 practitioners
Practice locations: Athens, AL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0899949North Alabama Primary Care1015 Highway 72 East Ste a, Athens, AL 35611Certificate of waiverJun 14, 2028

National Provider Directory

National Provider Directory

Locations

1015 US Highway 72 E
Ste A
Athens, AL 35611
Phone (256) 232-2505

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IIGBAA

Practitioners & affiliated clinicians

Practitioners 2

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": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1912118456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 HIGHWAY 72 EAST",
            "address_2": "SUITE 1",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "35611",
            "telephone_number": "256-232-2505",
            "fax_number": "256-230-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 HIGHWAY 72 EAST",
            "address_2": "SUITE 1",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "35611",
            "telephone_number": "256-232-2505",
            "fax_number": "256-230-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ALABAMA PRIMARY CARE,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "KONERU",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "256-232-2505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI3887",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.