NPIMap

Organization Active NPI

Monroe County Health Care Authority

Doing business as MCH Monroeville Medical Clinic

  • Family Medicine Physician
  • Monroeville, AL
National Provider Identifier
1992178552
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MONROE COUNTY HEALTH CARE AUTHORITY
Doing business as
MCH Monroeville Medical Clinic
Practice address
16 Medical Center Dr
Monroeville, AL 36460
Phone
(251) 575-3266
Fax
(251) 575-3262
NPI assigned
Nov 4, 2015
Last updated
Jul 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Authorized official

Name
Kathy S Johnson
Title
PFS Manager
Phone
(251) 743-7485

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

16 Medical Center Dr
Monroeville, AL 36460

Mailing address

PO Box 886
Monroeville, AL 36461-0886
Phone (251) 743-7485

Other names 1

  • MCH Monroeville Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160321001799 AL Part B Supplier - Clinic/Group Practice 2668365859 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
Practice locations: Monroeville, AL

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Atmore Community Hospital9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2016 S Alabama Ave
Ste C
Monroeville, AL 36460
Phone (251) 575-3111

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Monroe County HospitalMonroeville, AL, CCN 011310 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2025
Hospice of Monroe CountyMonroeville, AL, CCN 011685 Hospice Operational/Managerial Control (100%) Oct 1, 2019
MCH Rural Health ClinicMonroeville, AL, CCN 013483 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1992178552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 886",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "364610886",
            "telephone_number": "251-743-7485",
            "fax_number": "251-743-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MEDICAL CENTER DR",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "36460",
            "telephone_number": "251-575-3266",
            "fax_number": "251-575-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE COUNTY HEALTH CARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PFS MANAGER",
        "authorized_official_telephone_number": "251-743-7485"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCH Monroeville Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroeville, AL

Sources for this page

Verify at the official NPI Registry.