CUSTOM FAMILY CARE
NPI 1053839811
Family Medicine in Madison, AL

Q: What is Custom Family Care, LLC's NPI number?

The NPI number for Custom Family Care, LLC is 1053839811. It was assigned to this organization in the NPPES registry on August 31, 2017. The provider is doing business as Custom Family Care.

Q: What is Custom Family Care, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since August 31, 2017CLIA 01D2146280 · Microscopy

279 HUGHES RD, MADISON, AL 35758(256) 289-1733 Get Directions Write a Review

NPPES record last updated: June 2, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 2, 2021, Aug 31, 2017 (2 updates tracked since 2017).

On this page

About Custom Family Care NPPES

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

CUSTOM FAMILY CARE (NPI 1053839811) is a healthcare organization registered as a family medicine in Madison, Alabama and active in the NPI registry since August 2017. The organization holds a CLIA Microscopy certificate valid through March 26, 2028 and lists Ivan Pivovarov, President, as its authorized official.

NPPES Registry Identity

NPI1053839811

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameCUSTOM FAMILY CARE, LLC

Location Address279 HUGHES RDMadison, AL 35758-1142

Mailing Address279 Hughes RdMadison, AL 35758-1142

Phone(256) 289-1733

Organization SubpartNo

Authorized OfficialIvan PivovarovPresident · (256) 325-0480

Enumeration DateAugust 31, 2017

Last NPPES UpdateJune 2, 20212 updates tracked since enumeration

NPPES CertifiedJune 2, 2021

✔ NPI 1053839811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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 ListedClinic/Center · Urgent CareTaxonomy 261QU0200X

279 HUGHES RD, Madison, AL 35758

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Other Names 1

Doing Business AsCustom Family Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Custom Family Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Custom Family Care, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dawn Morris, CRNP, FNP-C

Nurse Practitioner

NPI 1598464307

101 FITNESS WAY STE 1200
Athens, AL 35611

(256) 232-0636

✔ PECOS✔ Accepts Medicare15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 for Provider-Performed Microscopy Procedures (PPMP) 01D2146280

Custom Family Care · Madison, AL

Active · expires Mar 26, 2028

CLIA Number01D2146280

Laboratory TypePhysician Office

Certificate Effective DateMarch 27, 2026

Certificate Expiration DateMarch 26, 2028

Laboratory DirectorIvan A. Pivovarov

Laboratory Phone(256) 325-0480

Laboratory LocationCustom Family Care279 Hughes Road, Madison, AL 35758

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Custom Family Care, LLC's NPI number?

The NPI number for Custom Family Care, LLC is 1053839811. It was assigned to this organization in the NPPES registry on August 31, 2017. The provider is doing business as Custom Family Care.

Where is Custom Family Care, LLC located?

Custom Family Care, LLC is located at 279 Hughes Rd, Madison, AL 35758. The listed phone number is (256) 289-1733.

What is Custom Family Care, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Custom Family Care, LLC enrolled in Medicare?

Yes. Custom Family Care, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Custom Family Care, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Custom Family Care, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Custom Family Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 01D2146280) is associated with this NPI, valid through March 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Custom Family Care, LLC was last updated on June 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.