NPIMap

Organization Active NPI

Management and Medical Services, LLC

Doing business as Childersburg Primary Care

  • Family Medicine Physician
  • Childersburg, AL
National Provider Identifier
1952484081
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MANAGEMENT AND MEDICAL SERVICES, LLC
Doing business as
Childersburg Primary Care
Practice address
34011 Highway 280 East
Childersburg, AL 35044
Phone
(256) 378-3313
Fax
(256) 378-3315
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mike Bice
Title
Administrator
Phone
(256) 378-3313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

34011 Highway 280 East
Childersburg, AL 35044

Mailing address

34011 Highway 280 East
Childersburg, AL 35044
Phone (256) 378-3313

Other names 1

  • CHILDERSBURG PRIMARY CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040127001203 AL Part B Supplier - Clinic/Group Practice 4981504172 Receives reassigned benefits from 5 practitioners
Practice locations: Childersburg, AL

National Provider Directory

National Provider Directory

Locations

3 Digital Dr
Ste 100
Birmingham, AL 35243
Phone (205) 672-7358

34 Town Hall Ln
Harpersville, AL 35078
Phone (205) 672-2272

1104 W Hickory St
Sylacauga, AL 35150
Phone (256) 378-3313

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952484081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34011 HIGHWAY 280 EAST",
            "city": "CHILDERSBURG",
            "state": "AL",
            "postal_code": "35044",
            "telephone_number": "256-378-3313",
            "fax_number": "256-378-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34011 HIGHWAY 280 EAST",
            "city": "CHILDERSBURG",
            "state": "AL",
            "postal_code": "35044",
            "telephone_number": "256-378-3313",
            "fax_number": "256-378-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAGEMENT AND MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BICE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-378-3313"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHILDERSBURG PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Childersburg, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.