IVY CREEK OF ELMORE LLC (NPI# 1649441650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649441650 |
| Entity Type | Organization |
| Organization Name | IVY CREEK OF ELMORE LLC |
| Other Organization Name | THE DOCTORS OFFICE |
| Practice Address |
7 Cambridge Court Wetumpka AL 36093-1261 |
| Mailing Address |
Po Box 130 Wetumpka AL 36092-0003 |
| Practice Telephone | 3345675626 |
| Practice Fax Number | 3345670855 |
| Mailing Telephone | 3345143820 |
| Mailing Fax Number | 3345674312 |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2011-03-21 |
| Authorized Official Name | MR. JAMES G FAULK (CEO) |
| Authorized Official Telephone | 3345674311 |
| Is Organization Subpart | Y |
| Parent Organization Name | IVY CREEK OF ELMORE LLC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| THE DOCTORS OFFICE | 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 |
| 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 |
| 1316246812 | Ivy Creek of Elmore LLC | Clinic/Center | 815 Jackson Trace Rd, Wetumpka, AL 36092-1504 | 2011-03-23 |
| 1790093029 | Ivy Creek of Elmore LLC | General Acute Care Hospital | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2010-09-21 |
| Street Address |
7 CAMBRIDGE COURT |
| City | WETUMPKA |
| State | AL |
| Zip Code | 36093-1261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699295907 | Katrina G Owes | Home Health Aide | 4037 Us Hwy 231, Wetumpka, AL 36093 | 2017-06-27 |
| 1194057554 | Wetumpka Urgent Care LLC | Clinic/Center | 11 Cambridge Drive, Wetumpka, AL 36093 | 2010-02-09 |
| 1376879478 | Ivy Creek of Elmore LLC | Otolaryngology | 53 Cambridge Court, Wetumpka, AL 36093 | 2009-10-23 |
| 1790815249 | Wetumpka Family Dentistry PC | Clinic/Center | 4045 Hwy 231, Wetumpka, AL 36093 | 2007-03-06 |
| 1962552448 | Ronaldo V Dejesus | Internal Medicine | 41 Cambridge Court, Wetumpka, AL 36093 | 2007-01-10 |
| 1538249149 | Bobby Joseph Luster | Chiropractor | 2412 Us Highway 231, Wetumpka, AL 36093-1209 | 2006-10-17 |
| 1942349626 | David Clark Young | Dentist | 4045 Us Highway 231, Wetumpka, AL 36093-1217 | 2007-02-06 |
| 1154784403 | Pharmix Rx LLC | Pharmacy | 66 Village Loop, Wetumpka, AL 36093-1221 | 2016-04-04 |
| 1700307113 | Sabrina Jackson | Home Health Aide | 4037 Us Highway 231 Ste B, Wetumpka, AL 36093-1224 | 2017-07-06 |
| 1427326834 | Clarence Dequan Merckerson | Counselor | 4035 Us Highway 231 Ste F, Wetumpka, AL 36093-1224 | 2011-12-13 |
| Find all providers in zip 36093 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568874543 | American Family Care, Inc. | General Practice | 4452 Us Highway 231, Wetumpka, AL 36092-3328 | 2014-05-27 |
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|---|---|---|---|---|
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| 1528561974 | Stephen David Thrasher | General Practice | 2215 California St Se, Huntsville, AL 35801-2706 | 2018-03-12 |
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| 1336662287 | Center Point Medical LLC | General Practice | 151 Woodham Dr, Albertville, AL 35951-3301 | 2017-07-24 |
| 1558898874 | B Vitality Pllc | General Practice | 3425 Colonnade Pkwy Ste C, Birmingham, AL 35243-2356 | 2017-05-17 |
| 1710438502 | Homewood Family Wellcare LLC | General Practice | 1 Independence Plz Ste 410, Homewood, AL 35209-2648 | 2016-10-17 |
| 1750837068 | Michelle R. Grana, Do; PC | General Practice | 470 Providence Main St Nw Ste 302a, Huntsville, AL 35806-4843 | 2016-08-27 |
| 1073964979 | Taurin Pyongkap Lee | General Practice | 2713 Downing St, Huntsville, AL 35801 | 2016-06-22 |
| 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.