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RUSSELLVILLE INTERNAL MEDICINE PC
NPI 1174715296
Internal Medicine in Russellville, AL

Active since August 13, 2007CLIA 01D1071850 · Waiver
535 GANDY ST NE, RUSSELLVILLE, AL 35653(256) 332-1120(256) 332-1198 Get Directions Write a Review

NPPES record last updated: October 25, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Russellville Internal Medicine Pc NPPES

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

RUSSELLVILLE INTERNAL MEDICINE PC (NPI 1174715296) is a healthcare organization registered as an internal medicine in Russellville, Alabama and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through August 1, 2027 and lists Miranda Decker, Md, as its authorized official.

NPPES Registry Identity

NPI1174715296
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameRUSSELLVILLE INTERNAL MEDICINE PC
Location Address535 GANDY ST NERussellville, AL 35653-1965
Mailing AddressPo Box 516Russellville, AL 35653-0516 · (256) 332-1120 · Fax (256) 332-1198
Phone(256) 332-1120
Fax(256) 332-1198
Organization SubpartNo
Authorized OfficialMiranda DeckerMd · (256) 332-1120
Enumeration DateAugust 13, 2007
Last NPPES UpdateOctober 25, 2024
NPPES CertifiedOctober 25, 2024
✔ NPI 1174715296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in AL · 28146
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
535 GANDY ST NE, Russellville, AL 35653
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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

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 01D1071850

Russellville Internal Medicine · Russellville, AL
Active · expires Aug 1, 2027
CLIA Number01D1071850
Laboratory TypePhysician Office
Certificate Effective DateAugust 2, 2025
Certificate Expiration DateAugust 1, 2027
Laboratory DirectorMiranda Decker MD
Laboratory Phone(256) 332-1120
Laboratory LocationRussellville Internal Medicine535 Gandy Street NE, Russellville, AL 35653
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

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

DR. MIRANDA DECKER MD
Internal Medicine
535 GANDY ST NE
RUSSELLVILLE, AL 35653
Franklin County (256) 332-1120

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 Russellville Internal Medicine PC's NPI number?

The NPI number for Russellville Internal Medicine PC is 1174715296. It was assigned to this organization in the NPPES registry on August 13, 2007.

Where is Russellville Internal Medicine PC located?

Russellville Internal Medicine PC is located at 535 Gandy St NE, Russellville, AL 35653. The listed phone number is (256) 332-1120.

What is Russellville Internal Medicine PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Russellville Internal Medicine PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D1071850) is associated with this NPI, valid through August 1, 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 Russellville Internal Medicine PC was last updated on October 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.