NPIMap

Organization Active NPI

Medcenter Primary Care, LLC

Doing business as MedCenter NorthRiver

  • Family Medicine Physician
  • Northport, AL
National Provider Identifier
1922546357
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDCENTER PRIMARY CARE, LLC
Doing business as
MedCenter NorthRiver
Practice address
4960 Rice Mine Road NE
Ste 10
Northport, AL 35476-2838
Phone
(205) 333-9467
Fax
(205) 758-1656
NPI assigned
Feb 6, 2017
Last updated
Jan 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Authorized official

Name
Beth Kohn
Title
Credentialing Specialist
Phone
(912) 756-2273

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X 9381 AL
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

4960 Rice Mine Road NE
Ste 10
Northport, AL 35476-2838

Mailing address

4960 Rice Mine Rd NE Ste 10
Tuscaloosa, AL 35406-3136
Phone (205) 333-9467

Other names 1

  • MedCenter NorthRiver Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170922001675 AL Part B Supplier - Clinic/Group Practice 3274807615 Receives reassigned benefits from 44 practitioners
Practice locations: Tuscaloosa, AL
O20190806002389 AL DME Supplier - Physician - Emergency MedicineDME Supplier - Nurse Practitioner 3274807615 Practice locations: Tuscaloosa, AL

National Provider Directory

National Provider Directory

Locations

122 17th Ct NE
Fayette, AL 35555
Phone (205) 330-1707

Practitioners & affiliated clinicians

Practitioners 64

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.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1922546357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 RICE MINE RD NE STE 10",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063136",
            "telephone_number": "205-333-9467",
            "fax_number": "205-333-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 RICE MINE ROAD NE",
            "address_2": "STE 10",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354762838",
            "telephone_number": "205-333-9467",
            "fax_number": "205-758-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCENTER PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "KOHN",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "912-756-2273"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AL",
            "license": "9381",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedCenter NorthRiver",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MedCenter NorthRiver",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northport, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; 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.