FAYETTE MEDICAL CENTER (NPI# 1245226430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245226430 |
| Entity Type | Organization |
| Organization Name | FAYETTE MEDICAL CENTER |
| Other Organization Name | FAYETTE MEDICAL CENTER LTC |
| Practice Address |
1653 Temple Ave N Fayette AL 35555-1314 |
| Mailing Address |
Po Box 710 Fayette AL 35555-0710 |
| Practice Telephone | 2053438500 |
| Practice Fax Number | 2059321257 |
| Mailing Telephone | 2059321112 |
| Mailing Fax Number | 2059321257 |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2019-08-29 |
| Authorized Official Name | KERI H HINDMAN (PATIENT ACCOUNTS DIRECTOR) |
| Authorized Official Telephone | 2027597378 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
12539 | AL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 4753120S | 05 | |
| AL | RAILROAD MEDICARE | CG6924 | 01 |
| AL | BLUE CROSS | 010124 | 01 |
| Other Name | Type Code |
|---|---|
| Fayette Medical Center LTC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629152822 | Fayette Medical Center | Hospice Care, Community Based | 120 15th Street Nw, Fayette, AL 35555-1526 | 2006-10-24 |
| 1841421757 | Fayette Medical Center | Surgery | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2009-07-28 |
| 1265516462 | Fayette Medical Center | Medicare Defined Swing Bed Unit | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2006-10-24 |
| 1851323836 | Fayette Medical Center | General Acute Care Hospital | 1653 Temple Ave N, Fayette, AL 35555 | 2006-07-07 |
| Street Address |
1653 TEMPLE AVE N |
| City | FAYETTE |
| State | AL |
| Zip Code | 35555-1314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093201543 | Relias Emergency Medicine Specialists of Fayette, LLC | Emergency Medicine | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2018-07-09 |
| 1952777336 | Jonataha Jones | Respiratory Therapist, Registered | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2015-08-19 |
| 1790167864 | Dakota S Acton Jones | Family Medicine | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2015-06-24 |
| 1194147637 | Fayette Medical Center-crna | Nurse Anesthetist, Certified Registered | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2014-01-17 |
| 1528312352 | Laura Caryn Goforth | Physical Therapy Assistant | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2012-10-31 |
| 1831440817 | Temple Emergency Group LLC | Physician Assistant | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2012-10-01 |
| 1841421757 | Fayette Medical Center | Surgery | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2009-07-28 |
| 1831394238 | Cynthia L Wright | Nurse Anesthetist, Certified Registered | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2007-06-18 |
| 1720163090 | Fayette Medical Center Ambulance | Ambulance | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2006-10-26 |
| 1265516462 | Fayette Medical Center | Medicare Defined Swing Bed Unit | 1653 Temple Ave N, Fayette, AL 35555-1314 | 2006-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982213021 | Brittany Nicole Pate | Pharmacist | 3186 Al-171 N, Fayette, AL 35555 | 2020-07-24 |
| 1942703020 | The Language Lab | Clinic/Center | 111 Columbus Street East, Fayette, AL 35555 | 2018-03-14 |
| 1407292709 | Lana Langley | Speech-Language Pathologist | 111 Columbus St E, Fayette, AL 35555 | 2013-05-14 |
| 1992096275 | Wendy Dawn Benton | Nurse Practitioner | 122 17th Court Ne, Fayette, AL 35555 | 2011-04-21 |
| 1699004929 | Patricia Lorraine Montgomery | Counselor | 123 2nd Avenue, Nw, Fayette, AL 35555 | 2009-12-16 |
| 1184826398 | Charles Thomas Webster | Pharmacist | 1116 2nd Ave Ne, Fayette Square Shopping Center, Fayette, AL 35555 | 2007-06-01 |
| 1114060381 | Fayette County Health Dept Adult Immun | Public Health or Welfare | 211 First Street, N.w., Fayette, AL 35555 | 2007-02-15 |
| 1356433064 | Dana Suzette Norris | Nurse Practitioner | 1653 Temple Ave N Ste 1, Fayette, AL 35555 | 2006-09-29 |
| 1992788871 | Air Evac Ems Inc | Ambulance | 108 21st St Ne, Fayette, AL 35555 | 2005-11-23 |
| 1255656112 | Debbie Kilgore Yerby | Pharmacist | 1716 Temple Avenue North, Fayette, AL 35555 | 2010-04-05 |
| Find all providers in zip 35555 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609099811 | Prairie View Management, Inc. | Custodial Care Facility | 18569 Lane Rd, Fayette, IA 52142-9525 | 2007-04-10 |
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| 1508241365 | Love Sitting and Service Care | Custodial Care Facility | 33 Ala Hwy 60, Arkon, AL 35441 | 2015-07-22 |
| 1295117125 | D Michele Jackson | Custodial Care Facility | 2620 River Haven Ln, Hoover, AL 35244-1273 | 2015-06-27 |
| 1487054300 | Divine Home Care | Custodial Care Facility | 802 Grant St Apt 3, Dothan, AL 36301-3807 | 2014-08-27 |
| 1629489380 | Comfort Healthcare Services LLC. | Custodial Care Facility | 623 Lewis Ave, Bessemer, AL 35020-6276 | 2014-05-15 |
| 1053662601 | Homeforheroes | Custodial Care Facility | 2024 Summer St Sw, Huntsville, AL 35805-3816 | 2012-09-23 |
| 1750663985 | Judy B. Haymon Homes, Inc. | Custodial Care Facility | 4693 Main Street-fyffe, Fyffe, AL 35971 | 2011-09-14 |
| 1942531256 | All In One Care Inc. | Custodial Care Facility | 1 23rd Ave Nw, Center Point, AL 35215-3445 | 2010-01-26 |
| 1053686089 | Four Winds/four Seasons Assisted Living Homes,llc | Custodial Care Facility | 2710 Deer Haven Dr, Northport, AL 35473-3048 | 2012-03-08 |
| 1154352524 | Gulf Health Hospitals Dba Oakwood Center for Living | Custodial Care Facility | 2010 Medical Center Dr, Bay Minette, AL 36507-4163 | 2006-07-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.