COOSA VALLEY SPORTS MEDICINE AND PRIMARY CARE LLC (NPI# 1871924357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871924357 |
| Entity Type | Organization |
| Organization Name | COOSA VALLEY SPORTS MEDICINE AND PRIMARY CARE LLC |
| Practice Address |
209 W Spring St Suite 305 Sylacauga AL 35150-2973 |
| Practice Telephone | 2562453201 |
| Practice Fax Number | 2562454112 |
| Mailing Telephone | 2562453201 |
| Mailing Fax Number | 2562454112 |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |
| Authorized Official Name | KENNIETH C MCCOLLOUGH (OWNER) |
| Authorized Official Telephone | 2562453201 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD.29754 | AL | Allopathic & Osteopathic Physicians |
| Street Address |
209 W SPRING ST SUITE 305 |
| City | SYLACAUGA |
| State | AL |
| Zip Code | 35150-2973 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114911518 | Nader Bishara | Pediatrics | 209 W Spring St, Suite 100, Sylacauga, AL 35150-2973 | 2005-08-31 |
| 1457802555 | Annie Clara Brown | Social Worker | 209 W Spring St, Suite 200, Sylacauga, AL 35150-2973 | 2016-10-24 |
| 1003261033 | Kristen Lawhorn | Nurse Practitioner | 209 W Spring St, Suite 300, Sylacauga, AL 35150-2973 | 2016-04-27 |
| 1073904561 | Laura Tubbs | Nurse Practitioner | 209 W Spring St, #300, Sylacauga, AL 35150-2973 | 2015-02-05 |
| 1083014658 | Pathway Pediatrics, Inc. | Pediatrics | 209 W Spring St, Suite 300, Sylacauga, AL 35150-2973 | 2014-09-02 |
| 1962790816 | Orthosports Associates, LLC | Orthopaedic Surgery | 209 W Spring St, Suite 301, Sylacauga, AL 35150-2973 | 2011-07-13 |
| 1770874695 | Anthony Jerome Nix Jr. | Family Medicine | 209 W Spring St, Suite 100, Sylacauga, AL 35150-2973 | 2011-04-26 |
| 1871723841 | Coosa Valley Homecare, LLC | Home Health | 209 W Spring St, Suite 305, Sylacauga, AL 35150-2973 | 2009-07-23 |
| 1912135542 | Tropeano Orthopaedics and Sports Medicine | Orthopaedic Surgery | 209 W Spring St, Suite 301, Sylacauga, AL 35150-2973 | 2009-06-22 |
| 1306071550 | William Thomas Wright | Social Worker | 209 W Spring St, Suite 304, Sylacauga, AL 35150-2973 | 2009-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245830934 | Casey Delane Sumner | Pharmacist | 1930 Pleasant Ridge Loop, Sylacauga, AL 35150 | 2020-10-30 |
| 1043870231 | Rehab and Wellness Clinic, LLC | Pain Medicine | 234 North Broadway, Sylacauga, AL 35150 | 2019-06-19 |
| 1366999195 | Tasia Bates Bradford | Nurse Practitioner | 209 W Spring St Ste 102, Sylacauga, AL 35150 | 2016-09-09 |
| 1083831804 | Coosa Valley Urology, P.C. | Specialist | 16 South Douglas Avenue, Sylacauga, AL 35150 | 2007-04-20 |
| 1689720641 | John Sidney Mcpeters | Dentist | 1604 Talladega Hwy, Dr John S Mcpeters, Sylacauga, AL 35150 | 2007-01-25 |
| 1972652386 | David Paul Currie | Dentist | 499 W 3rd St, Sylacauga, AL 35150 | 2007-01-09 |
| 1336221647 | Thomas M Kines | Optometrist | 493 W 3rd Street, Sylacauga, AL 35150 | 2006-10-19 |
| 1275623639 | Charles E. Singleton | Surgery | 208 West Spring Street, Suite 300, Sylacauga, AL 35150 | 2006-10-13 |
| 1881794410 | Said Y Salman | Durable Medical Equipment & Medical Supplies | 122 N Broadway Ave, Sylacauga, AL 35150 | 2006-09-24 |
| 1952416141 | Bruno's Supermarkets, LLC. | Durable Medical Equipment & Medical Supplies | 1301 West Ft Williams, Sylacauga, AL 35150 | 2006-08-20 |
| Find all providers in zip 35150 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962852053 | Nazia Mohamed | Internal Medicine | 209 W Spring St Ste 200, Sylacauga, AL 35150-2975 | 2016-06-20 |
| 1033388970 | Sylacauga Internal Medicine, LLC | Internal Medicine | 310 W Fort Williams St, Sylacauga, AL 35150-2434 | 2008-02-25 |
| 1326259300 | Omni Clinic Sylcauga | Internal Medicine | 303 N Main Ave, Sylacauga, AL 35150-2629 | 2007-05-24 |
| 1750395430 | William C Friday Jr. | Internal Medicine | 1106 W Magnolia Dr, Sylacauga, AL 35150-4522 | 2006-07-28 |
| 1649222753 | Abdalla Mohamed Elkhier | Internal Medicine | 400 W Fort Williams St, Sylacauga, AL 35150-2436 | 2006-05-17 |
| 1073757548 | Lhm Clinic, P.C. of Sylacauga | Internal Medicine | 303 N Main Ave, Sylacauga, AL 35150-2629 | 2009-04-28 |
| 1508966920 | Mahgoub Abdalla Eltoum | Internal Medicine | 209 West Spring Street, Suite 200, Sylacauga, AL 35150-2975 | 2006-09-25 |
| 1093725624 | Imad Khdair | Internal Medicine | 209 W Spring St, Suite 200, Sylacauga, AL 35150-2973 | 2006-08-08 |
| 1285648048 | Walter P Pinson | Internal Medicine | 209 W Spring St, Suite 200, Sylacauga, AL 35150-2973 | 2006-07-28 |
| 1689688111 | Stephen R Bowen | Internal Medicine | 209 W Spring St, Suite 200, Sylacauga, AL 35150-2973 | 2006-07-28 |
| Find all providers in SYLACAUGA | ||||
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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.