HALE COUNTY PHYSICIAN GROUP (HALE COUNTY HOSPITAL) NPI 1124356563

Emergency Medicine in Greensboro, AL

NPI 1124356563 Organization Emergency Medicine CLIA Number 01D0956778 CLIA Certificate of Waiver

About HALE COUNTY PHYSICIAN GROUP (HALE COUNTY HOSPITAL)

Hale County Physician Group (hale County Hospital) is a provider established in Greensboro, Alabama specializing in emergency medicine. The NPI number of Hale County Physician Group (hale County Hospital) is 1124356563 and was assigned on November 2009. The practitioner's primary taxonomy code is 207P00000X with license number H3301 (AL). The provider is registered as an organization and their NPI record was last updated 9 years ago. Hale County Physician Group (hale County Hospital) operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Hale County Physician Group. The authorized official of this NPI record is Thomas Ogden Lackey (Administrator)

The CLIA number of Hale County Physician Group is 01D0956778 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Hale County Physician Group 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

1124356563

Provider NameHALE COUNTY PHYSICIAN GROUP (HALE COUNTY HOSPITAL)
Provider Location Address508 GREENE ST GREENSBORO, AL 36744
Provider Mailing Address508 GREENE ST GREENSBORO, AL 36744
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Other Organization NameHALE COUNTY PHYSICIAN GROUP
Other Name TypeDoing Business As (3)
Enumeration Date11-23-2009
Last Update Date10-15-2012


Primary Taxonomy

Taxonomy Code207P00000X
ClassificationEmergency Medicine
TypeAllopathic & Osteopathic Physicians
License No.H3301
License StateAL
Taxonomy DescriptionAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Business Address

HALE COUNTY PHYSICIAN GROUP
508 GREENE ST
GREENSBORO, AL
ZIP 36744
Phone: (334) 624-3024
Fax: (334) 624-4453

Get Directions


Mailing Address

HALE COUNTY PHYSICIAN GROUP
508 GREENE ST
GREENSBORO, AL
ZIP 36744
Phone: (334) 624-3024
Fax: (334) 624-4453



Authorized Official

Authorized Official Name THOMAS OGDEN LACKEY
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(334) 624-3024

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 1124356563 is:

CLIA Number01D0956778
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


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

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1208M00000XAllopathic & Osteopathic PhysiciansHospitalistH3301ALNo

Taxonomy Description: hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

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
102G706409MEDICARE OSCAR/CERTIFICATION (06)AL

Other Providers at the same location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1700043767 JULIE SUZANNE ALDRIDGE
Individual
Nurse Practitioner508 GREENE ST
GREENSBORO, AL 36744
(334) 624-4442
1972823813 BOBBIE A CURTIS CRNP
Individual
Nurse Practitioner (Primary Care)508 GREENE ST
GREENSBORO, AL 36744
(334) 624-4442
1558464511HALE COUNTY HOSPITAL
Organization
Clinic/Center (Rural Health)508 GREENE ST
GREENSBORO, AL 36744
(334) 624-4442
1457422016MR. STEVEN GALVEZ CRNP
Individual
Nurse Practitioner (Family)508 GREENE ST
GREENSBORO, AL 36744
(334) 624-3024
1225068935HALE COUNTY HOSPITAL
Organization
General Acute Care Hospital508 GREENE ST
GREENSBORO, AL 36744
(334) 624-3024
1699005157HALE COUNTY HOSPITAL
Organization
Medicare Defined Swing Bed Unit508 GREENE ST
GREENSBORO, AL 36744
(334) 624-3024
1679939334 MEGAN DILLARD CRNP
Individual
Nurse Practitioner508 GREENE ST
GREENSBORO, AL 36744
(334) 624-3024
1386192557 ANNA HUGHEY COMPTON CRNP
Individual
Nurse Practitioner (Family)508 GREENE ST
GREENSBORO, AL 36744
(334) 624-4442
1801372149 JAMIE LYNN HANEY CRNP
Individual
Nurse Practitioner (Family)508 GREENE ST
GREENSBORO, AL 36744
(334) 624-3024
1053962639 IRIS KAY BESSIOUNI CRNP
Individual
Nurse Practitioner (Family)508 GREENE ST
GREENSBORO, AL 36744
(334) 624-6024

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.