FMC MEDICAL CLINIC MILLPORT NPI 1063871184

Family Medicine in Millport, AL

NPI 1063871184 Organization Family Medicine CLIA Number 01D2109911 CLIA Certificate of Waiver

About FMC MEDICAL CLINIC MILLPORT

Fmc Medical Clinic Millport is a primary care provider established in Millport, Alabama specializing in family medicine. The NPI number of Fmc Medical Clinic Millport is 1063871184 and was assigned on February 2016. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Fmc Medical Clinic Millport operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Mr. Ryan Campbell (Director Of Physician Service)

A primary care provider (PCP) like Fmc Medical Clinic Millport sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

The CLIA number of Fmc Medical Clinic Millport is 01D2109911 registered as a "rural health clinic" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Fmc Medical Clinic Millport to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1063871184

Provider NameFMC MEDICAL CLINIC MILLPORT
Provider Location Address13530 HIGHWAY 96 MILLPORT, AL 35576
Provider Mailing Address1820 RICE MINE RD N SUITE 200 TUSCALOOSA, AL 35406
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date02-17-2016
Last Update Date06-08-2016


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionFamily 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.

Business Address

FMC MEDICAL CLINIC MILLPORT
13530 HIGHWAY 96
MILLPORT, AL
ZIP 35576
Phone: (205) 662-3207
Fax: (205) 333-4660

Get Directions


Mailing Address

FMC MEDICAL CLINIC MILLPORT
1820 RICE MINE RD N
SUITE 200
TUSCALOOSA, AL
ZIP 35406
Phone: (205) 333-4661
Fax: (205) 333-4660



Authorized Official

Authorized Official NameMR. RYAN CAMPBELL
Authorized Official TitleDIRECTOR OF PHYSICIAN SERVICE
Authorized Official Phone(205) 759-6165

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1063871184 is:

CLIA Number01D2109911
Facility TypeRURAL HEALTH CLINIC
Certificate TypeCertificate of Waiver

Group Taxonomy


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

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
183355MEDICAID (05)AL
102G707924MEDICARE PIN (08)AL

Other Providers at the same location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1508851486 ROBERT ENOCH SWANSON CRNP
Individual
Nurse Practitioner (Family)13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-5784
1790177459LAMAR PRIMARY CARE LLC
Organization
Health Maintenance Organization13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-5784
1265561328MILLPORT FAM PRACTICE CLINIC, LLC
Organization
Clinic/Center13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-5784
1730593625MRS. HANNAH L LIVINGSTON CRNP
Individual
Nurse Practitioner13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-3207
1245233667 DAVID CLYDE CALL DO
Individual
Internal Medicine13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-3207
1902984032MILLPORT FAMILY PRACTICE CLINIC, LLC
Organization
Clinic/Center (Rural Health)13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-5784
1801975958MILLPORT INTERNAL MEDICINE
Organization
Clinic/Center (Medical Specialty)13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-5784

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.