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MED 360 URGENT CARE NORTHPORT LLC
NPI 1073238747
Family Medicine in Northport, AL

Active since October 05, 2022CLIA 01D2275483 · Certificate of Compliance
3250 MCFARLAND BLVD, NORTHPORT, AL 35476(205) 487-4535(205) 487-8875 Get Directions Write a Review

NPPES record last updated: October 8, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 8, 2024, Mar 7, 2024, Mar 29, 2023 and 2 more (5 updates tracked since 2022).

About Med 360 Urgent Care Northport Llc NPPES

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

MED 360 URGENT CARE NORTHPORT LLC (NPI 1073238747) is a healthcare organization registered as a family medicine in Northport, Alabama and active in the NPI registry since October 2022. The organization holds a CLIA Certificate of Compliance certificate valid through December 10, 2027 and lists Farouk A Raquib, Owner/ Md, as its authorized official.

NPPES Registry Identity

NPI1073238747
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMED 360 URGENT CARE NORTHPORT LLC
Location Address3250 MCFARLAND BLVDNorthport, AL 35476-3135
Mailing Address3250 Mcfarland Blvd Ste ANorthport, AL 35476-3135 · (205) 632-3875 · Fax (205) 462-3056
Phone(205) 487-4535
Fax(205) 487-8875
Organization SubpartNo
Authorized OfficialFarouk A RaquibOwner/ Md · (205) 326-3875
Enumeration DateOctober 5, 2022
Last NPPES UpdateOctober 8, 20245 updates tracked since enumeration
NPPES CertifiedOctober 8, 2024
✔ NPI 1073238747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
3250 MCFARLAND BLVD, Northport, AL 35476
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Other Identifiers 4

Medicaid322964AL
Other512-92816AL · Bcbs
Other1477511194AL · Npi
Medicaid315872AL

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Med 360 Urgent Care Northport Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Med 360 Urgent Care Northport LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (3)

Jennifer Josey, D.C., CRNP
Chiropractic
NPI 1669541843
125 BOB LAWRENCE DRIVE
Winfiled, AL 35594
(205) 487-4535
✔ PECOS✔ Accepts Medicare49 mi
Farouk Raquib, MD
Family Practice
NPI 1477511194
125 BOB LAWRENCE DRIVE
Winfield, AL 35594
(205) 487-4535
✔ PECOS49 mi
Kimberly Sprouse, FNP-C
Nurse Practitioner
NPI 1922549773
3189 HIGHWAY 45 N SUITE H
Columbus, MS 39705
(662) 570-4507
✔ PECOS✔ Accepts Medicare53 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 of Compliance 01D2275483

Med 360 Urgent Care Northport LLC · Northport, AL
Active · expires Dec 10, 2027
CLIA Number01D2275483
Laboratory TypePhysician Office
Certificate Effective DateDecember 11, 2025
Certificate Expiration DateDecember 10, 2027
Laboratory DirectorDr. Kavita R. Varm
Laboratory Phone(205) 632-3875
Laboratory LocationMed 360 Urgent Care Northport LLC3250 Mcfarland Blvd, Northport, AL 35476
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Med 360 Urgent Care Northport LLC's NPI number?

The NPI number for Med 360 Urgent Care Northport LLC is 1073238747. It was assigned to this organization in the NPPES registry on October 5, 2022.

Where is Med 360 Urgent Care Northport LLC located?

Med 360 Urgent Care Northport LLC is located at 3250 Mcfarland Blvd, Northport, AL 35476. The listed phone number is (205) 487-4535.

What is Med 360 Urgent Care Northport LLC's specialty?

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

Is Med 360 Urgent Care Northport LLC enrolled in Medicare?

Yes. Med 360 Urgent Care Northport LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Med 360 Urgent Care Northport LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Med 360 Urgent Care Northport LLC, in Chiropractic, Family Practice and Nurse Practitioner. 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 Med 360 Urgent Care Northport LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 01D2275483) is associated with this NPI, valid through December 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Med 360 Urgent Care Northport LLC was last updated on October 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.