NPIMap

Organization Active NPI

Dekalb Specialty Care

  • Multi-Specialty Clinic/Center
  • Fort Payne, AL
National Provider Identifier
1972366854
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
DEKALB SPECIALTY CARE
Practice address
200 Medical Center Dr SW
Fort Payne, AL 35968-3458
Phone
(256) 845-3150
NPI assigned
Feb 2, 2024
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
Clinton Carter, CFO
Title
Cfo
Phone
(256) 265-8818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

200 Medical Center Dr SW
Fort Payne, AL 35968-3458

Mailing address

PO Box 21007
Huntsville, AL 35813-5007
Phone (256) 801-6048

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240829001232 AL Part B Supplier - Clinic/Group Practice 5991244378 Receives reassigned benefits from 20 practitioners
Practice locations: Fort Payne, AL; Scottsboro, AL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

321 Medical Center Dr SW
Fort Payne, AL 35968
Phone (205) 845-4131

423 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 844-8144

550 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-6293

511 Main St W
Rainsville, AL 35986
Phone (256) 638-1100

307 Parks Ave
Scottsboro, AL 35768
Phone (256) 574-1566

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1972366854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21007",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358135007",
            "telephone_number": "256-801-6048",
            "fax_number": "256-801-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683458",
            "telephone_number": "256-845-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB SPECIALTY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "256-265-8818",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.