IVY CREEK OF ELMORE LLC (NPI# 1316246812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316246812 |
| Entity Type | Organization |
| Organization Name | IVY CREEK OF ELMORE LLC |
| Other Organization Name | WETUMPKA FAMILY RURAL HEALTH CLINIC |
| Practice Address |
815 Jackson Trace Rd Wetumpka AL 36092-1504 |
| Mailing Address |
Po Box 130 Wetumpka AL 36092-0003 |
| Practice Telephone | 3345672882 |
| Practice Fax Number | 3345673361 |
| Mailing Telephone | 3345672882 |
| Mailing Fax Number | 3345146747 |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2011-09-15 |
| Authorized Official Name | MR. MIKE BRUCE (CEO) |
| Authorized Official Telephone | 3345672882 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WETUMPKA FAMILY RURAL HEALTH CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376879478 | Ivy Creek of Elmore LLC | Otolaryngology | 53 Cambridge Court, Wetumpka, AL 36093 | 2009-10-23 |
| 1649441650 | Ivy Creek of Elmore LLC | General Practice | 7 Cambridge Court, Wetumpka, AL 36093-1261 | 2008-03-18 |
| 1467975581 | Ivy Creek of Elmore LLC | Internal Medicine | 807 Jackson Trace Rd, Wetumpka, AL 36092-1504 | 2017-07-20 |
| 1811421886 | Ivy Creek of Elmore LLC | Surgery | 515 Hospital Dr, Suite A, Wetumpka, AL 36092-1626 | 2017-04-17 |
| 1396031092 | Ivy Creek of Elmore LLC | General Acute Care Hospital | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2011-06-22 |
| 1790093029 | Ivy Creek of Elmore LLC | General Acute Care Hospital | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2010-09-21 |
| Street Address |
815 JACKSON TRACE RD |
| City | WETUMPKA |
| State | AL |
| Zip Code | 36092-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760406813 | Anne S Young | Specialist | 815 Jackson Trace Rd, Wetumpka, AL 36092-1504 | 2006-07-26 |
| 1154896082 | Heather K Hyde | Nurse Practitioner | 815 Jackson Trace Rd, Wetumpka, AL 36092-1504 | 2018-10-08 |
| 1821571357 | Carrie K Christian | Nurse Practitioner | 815 Jackson Trace Rd, Wetumpka, AL 36092-1504 | 2018-09-11 |
| 1952803843 | Maria Kathleen Calhoun | Registered Nurse | 815 Jackson Trace Rd, Wetumpka, AL 36092-1504 | 2018-03-06 |
| 1326555459 | Kasey Leigh Emmons | Registered Nurse | 815 Jackson Trace Rd, Wetumpka, AL 36092 | 2018-01-10 |
| 1518981687 | Melinda K Harden | Nurse Practitioner | 815 Jackson Trace Rd, Wetumpka, AL 36092-1504 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578195525 | River Region Family Medicine, LLC | Family Medicine | 277 Huntress Street, Suite 100, Wetumpka, AL 36092 | 2020-02-07 |
| 1710548003 | 2la, LLC | Hearing Instrument Specialist | 4354 Us Highway 231, Suite A, Wetumpka, AL 36092 | 2019-06-26 |
| 1124549308 | Medi - Rides Transport LLC | Non-emergency Medical Transport (VAN) | 173 Hill Street, Suite 103, Wetumpka, AL 36092 | 2017-06-28 |
| 1538699129 | Joni Smart | Pharmacist | 4538 Us Hwy 231, Wetumpka, AL 36092 | 2017-06-15 |
| 1134396898 | Blue Ridge Chiropractic, LLC | Chiropractor | 2412 Us Hwy 231, Wetumpka, AL 36092 | 2008-05-13 |
| 1932243565 | Patricia Dianne White Mcclanahan | Psychologist | 8476 U S Hwy 231 Admh Division of Intellectual Disabili, Comprehensive Support Svcs Riv & V, Wetumpka, AL 36092 | 2007-02-16 |
| 1952472607 | Wetumpka Family Practice Pa | Family Medicine | 73970 Tallassee Hwy, Wetumpka, AL 36092 | 2006-11-13 |
| 1063429744 | Jim G Anderson | Chiropractor | 76299 Tallassee Hwy, Wetumpka, AL 36092 | 2006-08-02 |
| 1710908009 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 5326 Hwy 231 South, Wetumpka, AL 36092 | 2006-07-21 |
| 1629011770 | Spencer J Coleman Sr. | Family Medicine | 73970 Tallassee Highway, Wetumpka, AL 36092 | 2006-06-14 |
| Find all providers in zip 36092 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396066650 | Ivycreek of Elmore LLC | Clinic/Center | 41 Cambridge Ct, Wetumpka, AL 36093-1261 | 2010-06-21 |
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| 1205309044 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 184 William E Hill Drive Ste C, Carrollton, AL 35447 | 2019-01-04 |
| 1487123915 | Physicians Care of Camden LLC | Clinic/Center | 24b Camden Byp, Camden, AL 36726-1770 | 2018-11-14 |
| 1336634666 | Central Pediatrics of Somerville LLC | Clinic/Center | 3609 Highway 67 S, Somerville, AL 35670 | 2018-06-28 |
| 1578060349 | Ivy Creek of Elmore, LLC | Clinic/Center | 4412 Hogan Rd, Deatsville, AL 36022-3400 | 2018-04-09 |
| 1568915106 | Physicians Care of Grove Hill LLC | Clinic/Center | 127 Clark St Ste C&d, Grove Hill, AL 36451-3050 | 2016-08-01 |
| 1205294428 | Red Bay Hospital Outpatient Clinics LLC | Clinic/Center | 14490 County Line Road, Suite A, Muscle Shoals, AL 35661 | 2016-02-02 |
| 1972985968 | Athens Limestone Pediatric Center LLC | Clinic/Center | 101 Fitness Way Ste 2100, Athens, AL 35611-2494 | 2015-06-25 |
| 1396125258 | D W Mcmillan Memorial Hospital | Clinic/Center | 1674 Cleveland Ave, Castleberry, AL 36432 | 2015-06-05 |
| 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.