NORTH DEKALB PRIMARY CARE, LLC (NPI# 1851898449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851898449 |
| Entity Type | Organization |
| Organization Name | NORTH DEKALB PRIMARY CARE, LLC |
| Practice Address |
106 45th St Ne Fort Payne AL 35967-4010 |
| Mailing Address |
38109 Us Highway 11 Valley Head AL 35989-4432 |
| Practice Telephone | 2563042109 |
| Practice Fax Number | 2563042157 |
| Mailing Telephone | 2569960540 |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2020-01-09 |
| Authorized Official Name | MR. JOHN MOORE (OWNER) |
| Authorized Official Telephone | 2569960540 |
| Authorized Official Credential | CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 136 Commerce Ave, Valley Head, AL 35989 | 2566741052 | 2566741054 |
| 888 County Road 9, Vernon, AL 355925280 | 2056951672 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Alabama Business Registrations | North DeKalb Primary Care, LLC | 38109 U.S. Highway 11, Valley Head, AL 35989 |
| Street Address |
106 45TH ST NE |
| City | FORT PAYNE |
| State | AL |
| Zip Code | 35967-4010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801211263 | Healthstat Onsite Clinic/heil Environmental | Preventive Medicine | 106 45th St Ne, Fort Payne, AL 35967-4010 | 2014-02-21 |
| 1386056216 | Northside Onsite Medical Services, Inc. | Family Medicine | 106 45th St Ne, Fort Payne, AL 35967-4010 | 2014-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073086922 | Ft Payne Careplus, LLC | Clinic/Center | 3000 Gault Ave North, Ft Payne, AL 35967 | 2019-01-03 |
| 1851739023 | Marlon Chad Williamson | Emergency Medicine | 617 Gault Ave N, Fort Payne, AL 35967 | 2013-06-11 |
| 1447552401 | Karole Kelley Ohme | Counselor | 216 Gault Avenue N, Relationship Clinic, Fort Payne, AL 35967 | 2010-11-24 |
| 1720112014 | Dekalb County Mr Board | Case Management | 117 First St Nw, Fort Payne, AL 35967 | 2007-03-16 |
| 1447275490 | Glynn Whiddon Odom | Nurse Anesthetist, Certified Registered | 200 Medical Center Drive, Fort Payne, AL 35967 | 2006-07-12 |
| 1477521698 | Michael Ray Parker | Optometrist | 900 Gault Ave S, Fort Payne, AL 35967 | 2006-03-14 |
| 1144204843 | Dale Ray Stierwalt | Family Medicine | 1618 Gault Ave. N., Fort Payne, AL 35967 | 2005-12-06 |
| 1417951112 | Barton Drake Ibsen | Physical Therapist | 121 Drinkard Dr, Fort Payne, AL 35967 | 2005-06-09 |
| 1407363146 | Tyson Scott Rainer | Nurse Practitioner | 1040 Glenn Blvd Sw, Fort Payne, AL 35967 | 2018-01-03 |
| 1801336599 | Caitlin Kirby | Massage Therapist | 216 Gault Ave N, Fort Payne, AL 35967 | 2017-03-01 |
| Find all providers in zip 35967 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801246178 | Oa Rwb LLC | Family Medicine | 1112 Glenn Boulevard Sw, Fort Payne, AL 35967-8486 | 2016-06-17 |
| 1285963421 | Scott Bradley Argo | Family Medicine | 2202 Jordan Rd Sw Ste 300, Fort Payne, AL 35968-3693 | 2009-12-17 |
| 1649209826 | Tomas Quiambao Pineda,jr. | Family Medicine | 1105 Cedarwood Dr Sw, Fort Payne, AL 35968-3613 | 2006-07-01 |
| 1225065022 | Doctors Med Care of Fort Payne, P.C. | Family Medicine | 1040 Glenn Blvd Sw, Fort Payne, AL 35967-8413 | 2006-06-27 |
| 1629019724 | Monique M. Sherrill | Family Medicine | 1202 Gault Ave N, Fort Payne, AL 35967-3040 | 2006-06-09 |
| 1265470900 | Elizabeth Dianne Cole | Family Medicine | 3840 Gault Ave N, Fort Payne, AL 35967-5211 | 2006-06-03 |
| 1144204843 | Dale Ray Stierwalt | Family Medicine | 1618 Gault Ave. N., Fort Payne, AL 35967 | 2005-12-06 |
| 1386056216 | Northside Onsite Medical Services, Inc. | Family Medicine | 106 45th St Ne, Fort Payne, AL 35967-4010 | 2014-05-27 |
| 1245560796 | Jason Anthony Ham | Family Medicine | 2202 Jordan Rd Sw Ste 300, Fort Payne, AL 35968-3693 | 2010-01-06 |
| 1164679676 | Rainsville Family Practice LLC | Family Medicine | 421 Medical Center Dr Sw, Fort Payne, AL 35968-3421 | 2008-08-26 |
| Find all providers in FORT PAYNE | ||||
| City | FORT PAYNE |
| Zip Code | 35967 |
Please comment or provide details below to improve the information on NORTH DEKALB PRIMARY CARE, LLC.
| 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.