IVY CREEK OF ELMORE, LLC (NPI# 1720309982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720309982 |
| Entity Type | Organization |
| Organization Name | IVY CREEK OF ELMORE, LLC |
| Other Organization Name | D/B/A ELMORE GERIATRIC SERVICES |
| Practice Address |
500 Hospital Dr Suite A Wetumpka AL 36092-1625 |
| Practice Telephone | 3345674311 |
| Practice Fax Number | 3345674312 |
| Mailing Telephone | 3345674311 |
| Mailing Fax Number | 3345674312 |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2010-09-22 |
| Authorized Official Name | 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 | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| d/b/a Elmore Geriatric Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578060349 | Ivy Creek of Elmore, LLC | Clinic/Center | 4412 Hogan Rd, Deatsville, AL 36022-3400 | 2018-04-09 |
| 1619098977 | Ivy Creek of Elmore, LLC | Specialist | 201 S Washington Street., Autaugaville, AL 36003 | 2007-04-03 |
| 1508480633 | Ivy Creek of Elmore, LLC | Family Medicine | 525 Hospital Dr, Wetumpka, AL 36092-1626 | 2020-06-04 |
| 1558868323 | Ivy Creek of Elmore, LLC | Clinic/Center | 2256 Gilmer Ave, Tallassee, AL 36078-7114 | 2018-04-09 |
| 1669733895 | Ivy Creek of Elmore, LLC | Hospitalist | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2012-06-05 |
| 1154642684 | Ivy Creek of Elmore, LLC | Surgery | 500 Hospital Dr, Suite B, Wetumpka, AL 36092-1625 | 2010-06-18 |
| 1144547712 | Ivy Creek of Elmore, LLC | Anesthesiology | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2010-04-22 |
| 1255533642 | Ivy Creek of Elmore, LLC | Home Health | 500 Hospital Drive, Wetumpka, AL 36092-1625 | 2007-06-05 |
| 1093838880 | Ivy Creek of Elmore, LLC | Preferred Provider Organization | 74186 Tallassee Hwy, Wetumpka, AL 36092-5643 | 2007-04-09 |
| 1588795942 | Ivy Creek of Elmore, LLC | General Acute Care Hospital | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2007-03-08 |
| Street Address |
500 HOSPITAL DR SUITE A |
| City | WETUMPKA |
| State | AL |
| Zip Code | 36092-1625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342184 | Ivy Creek Specialty Care | Emergency Medicine | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2020-10-05 |
| 1467069070 | Ivy Creek Specialty Care | Anesthesiology | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2020-09-28 |
| 1275919698 | Marlene Wilson-lavalley | Nurse Practitioner | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2015-08-07 |
| 1669733895 | Ivy Creek of Elmore, LLC | Hospitalist | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2012-06-05 |
| 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 |
| 1154642684 | Ivy Creek of Elmore, LLC | Surgery | 500 Hospital Dr, Suite B, Wetumpka, AL 36092-1625 | 2010-06-18 |
| 1144547712 | Ivy Creek of Elmore, LLC | Anesthesiology | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2010-04-22 |
| 1205034428 | Ivycreek of Elmore LLC | Emergency Medical Technician, Basic | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2007-07-10 |
| 1588795942 | Ivy Creek of Elmore, LLC | General Acute Care Hospital | 500 Hospital Dr, Wetumpka, AL 36092-1625 | 2007-03-08 |
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| 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 | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972115582 | Michael Shane Moore | Physical Medicine & Rehabilitation | 2757 Vandy Ct, Montgomery, AL 36110-1339 | 2020-08-17 |
| 1770108342 | Oates Healthcare Services Inc | Physical Medicine & Rehabilitation | 8832 Kenston Ct, Mobile, AL 36619-4354 | 2020-06-10 |
| 1689227191 | Abm Rehab LLC | Physical Medicine & Rehabilitation | 1503 Big Cove Rd Se, Huntsville, AL 35801-2115 | 2019-07-23 |
| 1609438498 | T & C Rehab, LLC | Physical Medicine & Rehabilitation | 650 9th Ave Sw Ste 104, Bessemer, AL 35022-4502 | 2019-07-02 |
| 1912462342 | Connor Michael Brown | Physical Medicine & Rehabilitation | 5266 Creekside Loop, Hoover, AL 35244-3982 | 2019-02-11 |
| 1215419122 | Bayside Orthopedic & Rehabilitation Center, P.C. | Physical Medicine & Rehabilitation | 1121 Belleville Ave Ste A, Brewton, AL 36426-1502 | 2018-09-06 |
| 1275013351 | Therapy South - Florence LLC | Physical Medicine & Rehabilitation | 3226 Florence Blvd, Florence, AL 35634 | 2018-08-17 |
| 1568952679 | Equilibrium Pt, LLC | Physical Medicine & Rehabilitation | 2415 Moores Mill Rd Unit 210, Auburn, AL 36830-8482 | 2018-05-14 |
| 1326564097 | Sarah Klein | Physical Medicine & Rehabilitation | 2701 Frederick Rd Ste 306, Opelika, AL 36801-7281 | 2017-08-15 |
| 1356885362 | Valley Spine and Pain LLC | Physical Medicine & Rehabilitation | 2227 Drake Ave Sw Ste 7b, Huntsville, AL 35805 | 2016-12-09 |
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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.