NPIMap

Organization Active NPI

Southern Family Medicine, PC

  • Family Medicine Physician
  • Boaz, AL
National Provider Identifier
1962511600
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00025564 Issued in AL
Legal business name
SOUTHERN FAMILY MEDICINE, PC
Practice address
2367 US Hwy 431
Boaz, AL 35957
Phone
(256) 840-4571
Fax
(256) 840-4534
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Authorized official

Name
Angela L Clifton, MD
Title
Owner
Phone
(256) 891-7171

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 00025564 AL Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 0025564 AL

Addresses

Primary practice location

2367 US Hwy 431
Boaz, AL 35957

Mailing address

PO Box 1290
Boaz, AL 35957
Phone (256) 840-4571

Other identifiers 3

IdentifierTypeStateIssuer
7395705OtherAETNA
529925850MedicaidAL
0102051OtherUNITED HEALTHCARE

National Provider Directory

National Provider Directory

Locations

4198 US Highway 431
Ste G
Albertville, AL 35950
Phone (256) 878-9912

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1962511600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1290",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "35957",
            "telephone_number": "256-840-4571",
            "fax_number": "256-840-4534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2367 US HWY 431",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "35957",
            "telephone_number": "256-840-4571",
            "fax_number": "256-840-4534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "CLIFTON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-891-7171",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00025564",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "0025564",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7395705",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529925850",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0102051",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boaz, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.