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ADERHOLT MEDICAL, LLC
NPI 1164023529
Family Medicine in Athens, AL

Active since November 03, 2020CLIA 01D2210712 · Waiver
111 S MARION ST STE B, ATHENS, AL 35611(256) 230-5280(256) 427-4117 Get Directions Write a Review

NPPES record last updated: March 26, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 26, 2026, Nov 3, 2020 (2 updates tracked since 2020).

About Aderholt Medical, Llc NPPES

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

ADERHOLT MEDICAL, LLC (NPI 1164023529) is a healthcare organization registered as a family medicine in Athens, Alabama and active in the NPI registry since November 2020. The organization holds a CLIA Waiver certificate valid through January 21, 2027 and lists Brady Eric Aderholt, Owner, as its authorized official.

NPPES Registry Identity

NPI1164023529
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameADERHOLT MEDICAL, LLC
Location Address111 S MARION ST STE BAthens, AL 35611-2552
Mailing Address111 S Marion St Ste BAthens, AL 35611-2552 · (256) 230-5280 · Fax (256) 427-4117
Phone(256) 230-5280
Fax(256) 427-4117
Organization SubpartNo
Authorized OfficialBrady Eric AderholtOwner · (256) 777-1278
Enumeration DateNovember 3, 2020
Last NPPES UpdateMarch 26, 20262 updates tracked since enumeration
NPPES CertifiedMarch 26, 2026
✔ NPI 1164023529 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.
111 S MARION ST STE B, Athens, AL 35611
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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)

Aderholt Medical, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Aderholt Medical, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Brady Aderholt, CRNP
Nurse Practitioner
NPI 1306293618
111 S MARION ST STE B
Athens, AL 35611
(256) 230-5280
✔ PECOS✔ Accepts MedicareSame address
Evangeleine Bates, NURSE PRACTITIONER
Nurse Practitioner
NPI 1508216649
111 S MARION ST STE B
Athens, AL 35611
(256) 230-5280
✔ PECOS✔ Accepts MedicareSame address
Zachary Curtis, CRNP
Nurse Practitioner
NPI 1003404856
700 W MARKET ST
Athens, AL 35611
(256) 233-9292
✔ PECOS✔ Accepts Medicare0.5 mi
Martin Schreeder, MD
Emergency Medicine
NPI 1477845881
700 W MARKET ST
Athens, AL 35611
(256) 233-9151
✔ PECOS✔ Accepts Medicare0.5 mi
Tyneishia King
Nurse Practitioner
NPI 1235788415
1207 E FORREST ST STE 204D
Athens, AL 35613
(256) 230-5280
✔ PECOS✔ Accepts Medicare1.1 mi
Buffy Gray, NP
Nurse Practitioner
NPI 1609551563
105 FIRE STATION RD
Baileyton, AL 35019
(256) 735-4057
✔ PECOS42 mi
Charles Gray, FNP-BC
Nurse Practitioner
NPI 1144801143
105 FIRE STATION RD
Baileyton, AL 35019
(256) 735-4057
✔ PECOS✔ Accepts Medicare42 mi
Scott Buckner, M.D.
Internal Medicine
NPI 1316332281
5001 HARDY ST
Hattiesburg, MS 39402
(601) 296-2090
✔ PECOS277 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 Waiver 01D2210712

Aderholt Medical, LLC · Athens, AL
Active · expires Jan 21, 2027
CLIA Number01D2210712
Laboratory TypeMobile Laboratory
Certificate Effective DateJanuary 22, 2025
Certificate Expiration DateJanuary 21, 2027
Laboratory DirectorBrandi S. Ray
Laboratory Phone(256) 230-5280
Laboratory LocationAderholt Medical, LLC108 Shady Lane, Athens, AL 35613
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only 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 Aderholt Medical, LLC's NPI number?

The NPI number for Aderholt Medical, LLC is 1164023529. It was assigned to this organization in the NPPES registry on November 3, 2020.

Where is Aderholt Medical, LLC located?

Aderholt Medical, LLC is located at 111 S Marion St Ste B, Athens, AL 35611. The listed phone number is (256) 230-5280.

What is Aderholt Medical, LLC's specialty?

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

Is Aderholt Medical, LLC enrolled in Medicare?

Yes. Aderholt Medical, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Aderholt Medical, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Aderholt Medical, 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. The largest specialties are Nurse Practitioner (6), Emergency Medicine (1) and Internal Medicine (1). Of these, 2 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Aderholt Medical, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D2210712) is associated with this NPI, valid through January 21, 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 Aderholt Medical, LLC was last updated on March 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.