RUSSELLVILLE HOSPITAL LLC - NPI 1033253141 - Family Medicine in Russellville, AL

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

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About Russellville Hospital Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RUSSELLVILLE HOSPITAL LLC (NPI 1033253141) is a healthcare organization registered as a family medicine in Russellville, Alabama and active in the NPI registry since February 2007. The organization lists Donald J. Bivacca, President, as its authorized official.

NPPES Registry Identity

NPI1033253141

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameRUSSELLVILLE HOSPITAL LLC

Location Address15155 HIGHWAY 43Russellville, AL 35653-1975

Mailing Address330 Seven Springs WayBrentwood, TN 37027-4536 · (615) 920-7000 · Fax (615) 920-8913

Phone(256) 332-1611

Organization SubpartNo

Authorized OfficialDonald J. BivaccaPresident · (615) 920-7000

Enumeration DateFebruary 20, 2007

Last NPPES UpdateJuly 28, 2014

✔ NPI 1033253141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

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.

Also ListedAnesthesiologyTaxonomy 207L00000X

Also ListedEmergency MedicineTaxonomy 207P00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X

Also ListedSurgeryTaxonomy 208600000X

15155 HIGHWAY 43, Russellville, AL 35653

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Other Identifiers 1

Medicare ID-Type UnspecifiedJ135

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 01D0984340

Russellville Dialysis · Russellville, AL

Active · expires Mar 19, 2027

CLIA Number01D0984340

Laboratory TypeEnd Stage Renal Disease Dialysis Facility

Certificate Effective DateMarch 20, 2025

Certificate Expiration DateMarch 19, 2027

Laboratory DirectorRajesh Boorgu

Laboratory Phone(256) 332-7044

Laboratory LocationRussellville Dialysis14897 Highway 43, Russellville, AL 35653

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARC EDWARD BERRY M.D.

Emergency Medicine