Harrison Matthew Fuqua, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS18974 Issued in FL

Practice address

4284 Kelson Ave
Marianna, FL 32446-2948

Phone

(850) 482-2910

NPI assigned

Sep 4, 2019

Last updated

Nov 22, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Alabama College of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Alabama Physicians, LLPGroup PAC ID 0143379388, 12 clinicians

ER Physician Group at Jackson HospitalGroup PAC ID 8729059472, 153 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Hospice Birmingham Hospice, Hoover, AL, CCN 011543
• Enhabit Hospice Prattville Hospice, Montgomery, AL, CCN 011600
• Medical Center Enterprise Hospital, Enterprise, AL, CCN 010049
• Jackson Hospital Hospital, Marianna, FL, CCN 100142
• Flowers Hospital Hospital, Dothan, AL, CCN 010055
• Medical Center Enterprise Nursing home, CCN 01U049

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: harrisonfuqua@jh.allscriptsdirect.net

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.

• ER Physician Group at Jackson Hospital

  • General Practice Physician
  • Marianna, FL
  • NPI 1407801194
  Medicare reassignment Care Compare group NPD
• Northern Alabama Physicians, LLP

  • Emergency Medicine Physician
  • Decatur, AL
  • NPI 1669618310
  Medicare reassignment Care Compare group NPD
• Chilton Family Care, LLC

  • Family Medicine Physician
  • Clanton, AL
  • NPI 1366857674
  Medicare reassignment NPD
• Enterprise Urgent Care

  dba Ivy Creek Family Care of Enterprise

  • Urgent Care Clinic/Center
  • Enterprise, AL
  • NPI 1285180729
  Medicare reassignment NPD
• Ess of Eufaula, LLC

  • Emergency Medicine Physician
  • Eufaula, AL
  • NPI 1013650456
  Medicare reassignment NPD
• Ess of Luverne LLC

  • Emergency Medicine Physician
  • Luverne, AL
  • NPI 1457953473
  Medicare reassignment NPD
• Ivy Creek of Elmore, LLC

  dba Ivy Creek Family Care of Tallassee

  • Rural Health Clinic/Center
  • Tallassee, AL
  • NPI 1558868323
  Medicare reassignment NPD
• Ivy Creek of Tallapoosa LLC

  dba Lake Martin Family Medicine

  • Rural Health Clinic/Center
  • Dadeville, AL
  • NPI 1932130002

  Family Medicine

  Medicare reassignment NPD
• Southern Alabama Physicians LLP

  • Emergency Medicine Physician
  • Dothan, AL
  • NPI 1467701490
  Medicare reassignment NPD
• Wetumpka Urgent Care LLC

  • Urgent Care Clinic/Center
  • Wetumpka, AL
  • NPI 1194057554
  Medicare reassignment NPD
• Keystone Hospitalist Services of Alabama, Inc.

  • Hospitalist Physician
  • Troy, AL
  • NPI 1275478232
  Medicare reassignment
• Ivy Creek of Elmore, LLC

  dba Ivy Creek Family Care of Wetumpka

  • Rural Health Clinic/Center
  • Wetumpka, AL
  • NPI 1508480633

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jackson County Hospital District

  • General Acute Care Hospital
  • Marianna, FL
  • NPI 1538108725
  Care Compare affiliation
• Camellia Hospice of South Alabama, LLC

  dba Enhabit Hospice Prattville

  • Community Based Hospice Care Agency
  • Montgomery, AL
  • NPI 1053856591
  Care Compare affiliation
• Eh Health Hospice of Alabama, LLC

  dba Enhabit Hospice Birmingham

  • Community Based Hospice Care Agency
  • Hoover, AL
  • NPI 1609337229
  Care Compare affiliation
• QHG of Enterprise Inc

  dba Medical Center Enterprise

  • Medicare Defined Swing Bed Hospital Unit
  • Enterprise, AL
  • NPI 1083157275

  Nursing home

  Care Compare affiliation
• QHG of Enterprise Inc

  dba Medical Center Enterprise

  • General Acute Care Hospital
  • Enterprise, AL
  • NPI 1720039712
  Care Compare affiliation
• Triad of Alabama LLC

  dba Flowers Hospital

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1801830500
  Care Compare affiliation

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1972152791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 HOSPITAL DR",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324461917",
            "telephone_number": "850-526-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4284 KELSON AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462948",
            "telephone_number": "850-482-2910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4371 Narrow Lane Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361162975",
            "country_code": "US",
            "telephone_number": "334-613-3680",
            "fax_number": "334-613-3685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1798 Georgia St",
            "address_purpose": "LOCATION",
            "city": "Alford",
            "state": "FL",
            "postal_code": "324206800",
            "country_code": "US",
            "telephone_number": "850-526-6727",
            "fax_number": "850-526-1027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4896 Highway 90 Ste A",
            "address_purpose": "LOCATION",
            "city": "Marianna",
            "state": "FL",
            "postal_code": "324467840",
            "country_code": "US",
            "telephone_number": "850-526-6700",
            "fax_number": "850-526-6701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "HARRISON",
        "middle_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-04",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.2441",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS18974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Focus Physical Therapy and Work Rehab Center, LLC
• Kristy M. Ford, PH.D, LMHC
• Four Seasons Counseling,LLC
• Donna Fowler, DNP, NP-C, FNP-BC
• Ft Walton Open MRI LLC (Airis Open MRI of Marianna)
• Gainesville Vamc
• Tonya Thompson Gardner, M.S.
• Ashley Leanne Garrett, APRN
• Joe Howard Gay, MEDICAL DOCTOR
• George L Sanchez, MD

• Family Medicine Physician in Marianna, FL
• Providers in Marianna, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.