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AGAPE MEDICAL CLINIC PC
NPI 1174643852
Nurse Practitioner - Family in Hamilton, AL

Active since March 29, 2007CLIA 01D1008850 · Waiver
1911 MILITARY ST S, HAMILTON, AL 35570(205) 952-9603(205) 952-9661 Get Directions Write a Review

NPPES record last updated: November 10, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Agape Medical Clinic Pc NPPES

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

AGAPE MEDICAL CLINIC PC (NPI 1174643852) is a healthcare organization registered as a family in Hamilton, Alabama and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through January 28, 2027 and lists Dorothy E Stidham, President, as its authorized official.

NPPES Registry Identity

NPI1174643852
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameAGAPE MEDICAL CLINIC PC
Location Address1911 MILITARY ST SHamilton, AL 35570
Mailing AddressPo Box 2282Hamilton, AL 35570 · (205) 952-9603 · Fax (205) 952-9661
Phone(205) 952-9603
Fax(205) 952-9661
Organization SubpartNo
Authorized OfficialDorothy E StidhamPresident · (205) 952-9603
Enumeration DateMarch 29, 2007
Last NPPES UpdateNovember 10, 2022
NPPES CertifiedNovember 10, 2022
✔ NPI 1174643852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AL · 1061751
1911 MILITARY ST S, Hamilton, AL 35570
Open in Google Maps ↗

Other Identifiers 1

Medicaid051552982STIAL

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

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 01D1008850

Agape Medical Clinic PC · Hamilton, AL
Active · expires Jan 28, 2027
CLIA Number01D1008850
Laboratory TypeCommunity Clinic
Certificate Effective DateJanuary 29, 2025
Certificate Expiration DateJanuary 28, 2027
Laboratory DirectorVanessa A. Ragland-Payne Do
Laboratory Phone(205) 952-9603
Laboratory LocationAgape Medical Clinic PC1911 Military Street South, Hamilton, AL 35570
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRENTENEY FORTUNE FNP-C, CRNP
Nurse Practitioner (Family)
1911 MILITARY ST S
HAMILTON, AL 35570
Marion County (205) 952-9603
DOROTHY ELLEN STIDHAM CRNP
Nurse Practitioner (Family)
1911 MILITARY ST S
HAMILTON, AL 35570
Marion County (205) 952-9603
BRITNEY B SULLINS CRNP
Nurse Practitioner (Family)
1911 MILITARY ST S
HAMILTON, AL 35570
Marion County (205) 952-9603

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 Agape Medical Clinic PC's NPI number?

The NPI number for Agape Medical Clinic PC is 1174643852. It was assigned to this organization in the NPPES registry on March 29, 2007.

Where is Agape Medical Clinic PC located?

Agape Medical Clinic PC is located at 1911 Military St S, Hamilton, AL 35570. The listed phone number is (205) 952-9603.

What is Agape Medical Clinic PC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Agape Medical Clinic PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D1008850) is associated with this NPI, valid through January 28, 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 Agape Medical Clinic PC was last updated on November 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.