Ivy Creek Family Care of Enterprise

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

IVY CREEK FAMILY CARE OF ENTERPRISE

Doing business as

Ivy Creek Family Care of Enterprise

Practice address

6582 Boll Weevil Cir Ste B
Enterprise, AL 36330-9424

Phone

(334) 347-2027

Fax

(334) 347-2299

NPI assigned

Feb 3, 2025

Organization subpart

No

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

Authorized official

Name

Jade Lane

Title

Credentialing Manager

Phone

(334) 567-4311

Specialties & licenses 1

Addresses

Other names 1

• IVY CREEK FAMILY CARE OF ENTERPRISE Doing business as

Locations

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1972317741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360920003",
            "telephone_number": "334-567-4311",
            "fax_number": "334-512-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6582 BOLL WEEVIL CIR STE B",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363309424",
            "telephone_number": "334-347-2027",
            "fax_number": "334-347-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY CREEK FAMILY CARE OF ENTERPRISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "JADE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "334-567-4311"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IVY CREEK FAMILY CARE OF ENTERPRISE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lashay Jackson, LPC
• Billy Jacobs III, PA-C
• James E Flowers MD PC
• Shekia L James
• Emily Jeffreys, FNP-C

• Primary Care Clinic/Center in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.