NPIMap

Individual provider Active NPI

Manuel Pouparina, M.D.

  • Internal Medicine Physician
  • Fort Campbell, KY
National Provider Identifier
1942240445
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
72530 Issued in TN
Practice address
650 Joel Drive
Fort Campbell, KY 42223
Phone
(931) 431-2800
Fax
(615) 225-6864
NPI assigned
Jun 7, 2006
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 72530 TN Primary

Addresses

Primary practice location

650 Joel Drive
Fort Campbell, KY 42223

Mailing address

650 Joel Dr
Fort Campbell, KY 42223-8355
Phone (931) 431-2800

Other identifiers 1

IdentifierTypeStateIssuer
051545593MedicaidTN

Other names 1

  • Manuel Pouparina Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071228000039 AL Practitioner - Family Practice 0244278828 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72530TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Health Services Inc Current Accepting new patients
Manuel Pouparina MD LLC CurrentSince Oct 1, 2011 Accepting new patients
Providence Hospital CurrentSince Jun 15, 2021 Accepting new patients
Health Services Inc CurrentSince Apr 1, 2022 Accepting new patients
Providence Hospital Current Accepting new patients
Providence Hospital CurrentSince Jun 15, 2021 Accepting new patients
Health Services Inc CurrentSince Apr 1, 2022 Accepting new patients
Gilberto Seco MD and Associates,Inc Past Accepting new patients
VNL Medical Association Corp Past Accepting new patients

Locations

203 N Taylor St
Autaugaville, AL 36003
Phone (334) 263-2301

511 E Tuskeena St
Hayneville, AL 36040
Phone (334) 548-2516

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

33 Salem Rd
#2
Montevallo, AL 35115

2611 Woodley Park Dr
Montgomery, AL 36116
Phone (334) 288-0009

3058 Mobile Hwy
Montgomery, AL 36108
Phone (334) 293-6670

5422 State Highway 94
Ramer, AL 36069
Phone (334) 562-3229

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hayneville Family Health CenterHayneville, AL, CCN 011979 Federally qualified health center Corporate Officer Apr 4, 2022
Autaugaville Family Health CenterAutaugaville, AL, CCN 011982 Federally qualified health center Corporate Officer Apr 4, 2022
Clanton Family Health CenterClanton, AL, CCN 011977 Federally qualified health center Corporate Officer Apr 4, 2022
Chisholm Family Health CenterMontgomery, AL, CCN 011981 Federally qualified health center Corporate Officer Apr 4, 2022
Gateway Family Health CenterMontgomery, AL, CCN 011806 Federally qualified health center Corporate Officer Apr 4, 2022
Montgomery East Family Health CenterMontgomery, AL, CCN 011008 Federally qualified health center Corporate Officer Apr 4, 2022

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1942240445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422238355",
            "telephone_number": "931-431-2800",
            "fax_number": "615-225-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DRIVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "931-431-2800",
            "fax_number": "615-225-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUPARINA",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "72530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051545593",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANUEL",
            "last_name": "POUPARINA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Campbell, KY

Sources for this page

Verify at the official NPI Registry.