PICKENS COUNTY PRIMARY CARE, P.C (NPI# 1508332446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508332446 |
| Entity Type | Organization |
| Organization Name | PICKENS COUNTY PRIMARY CARE, P.C |
| Practice Address |
815 7th Ave Sw Reform AL 35481 |
| Mailing Address |
108 4th Ave Sw Ste A Reform AL 35481-8018 |
| Practice Telephone | 2053752438 |
| Practice Fax Number | 2053752439 |
| Mailing Telephone | 2053756251 |
| Mailing Fax Number | 2053759064 |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2020-02-19 |
| Authorized Official Name | JULIA L BOOTHE (OWNER) |
| Authorized Official Telephone | 2057926701 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PICKENS COUNTY PRIMARY CARE, P.C |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| RES Smart | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063988806 | Pickens County Primary Care, P.c | Family Medicine | 630 4th St Nw, Gordo, AL 35466 | 2018-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PICKENS COUNTY PRIMARY CARE, P.C. | 108 4th Avenue Sw Ste A, Reform, AL 35481-8018 |
| Street Address |
815 7TH AVE SW |
| City | REFORM |
| State | AL |
| Zip Code | 35481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003476714 | Growing In The Dark Counseling Services | Counselor | 402 3rd Ave Sw, Reform, AL 35481 | 2019-06-14 |
| 1679824684 | Kristin Hamner | Occupational Therapy Assistant | 515 2nd Avenue Nw, Reform, AL 35481 | 2012-10-01 |
| 1750509394 | Meredith L Mettee | Home Health | 216 1st St S, Reform, AL 35481 | 2007-04-20 |
| 1043313661 | Landreth & Associates Inc | Optometrist | 311 1st Street, Reform, AL 35481 | 2006-09-07 |
| 1780627356 | Harry Lee Richardson Jr. | Emergency Medicine | 514 10th Ave Sw, Reform, AL 35481 | 2006-06-13 |
| 1356381222 | Reform Pharmacy Inc | Pharmacy | 211 1st Street South, Reform, AL 35481 | 2006-06-07 |
| 1437626868 | Pickens County Primary Care, PC | Family Medicine | 205 4th Ave, Reform, AL 35481 | 2018-10-24 |
| 1457774200 | Cacyce Fowler | Nurse Practitioner | 108 4th Ave Sw Ste A, Reform, AL 35481 | 2014-01-30 |
| 1023303013 | Brenda Sue Robertson | Physical Therapy Assistant | 515 2nd Ave Nw, Reform, AL 35481 | 2011-06-17 |
| 1134440894 | Reform Rural Health Center PC | Family Medicine | 514 10th Ave Sw, Reform, AL 35481 | 2010-06-17 |
| Find all providers in zip 35481 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790021533 | Pickens County Medical Center, Inc | Clinic/Center | 514 10th Ave Sw, Reform, AL 35481-2114 | 2012-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205753 | Pickens County Primary Care PC | Clinic/Center | 99 Commerce Avenue, Carrollton, AL 35447 | 2020-11-06 |
| 1952952541 | Pediatric Associates of Alexander City PC | Clinic/Center | 21 Coosa County Road 50, Kellyton, AL 35089-1900 | 2019-09-25 |
| 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.