MILLPORT FAM PRACTICE CLINIC, LLC NPI 1265561328

Clinic/Center in Millport, AL

NPI 1265561328 Organization Clinic/Center

About MILLPORT FAM PRACTICE CLINIC, LLC

Millport Fam Practice Clinic, Llc is a provider established in Millport, Alabama specializing in clinic/center. The NPI number of Millport Fam Practice Clinic, Llc is 1265561328 and was assigned on March 2007. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Dr. Robert E Swanson Dnp, Crnp (Managing Partner)

NPI

1265561328

Provider NameMILLPORT FAM PRACTICE CLINIC, LLC
Provider Location Address13530 HIGHWAY 96 MILLPORT, AL 35576
Provider Mailing Address13530 HIGHWAY 96 MILLPORT, AL 35576
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date03-05-2007
Last Update Date05-28-2015


Primary Taxonomy

Taxonomy Code261Q00000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
Taxonomy DescriptionA facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Business Address

MILLPORT FAM PRACTICE CLINIC, LLC
13530 HIGHWAY 96
MILLPORT, AL
ZIP 35576
Phone: (205) 662-5784
Fax: (205) 662-5786

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Mailing Address

MILLPORT FAM PRACTICE CLINIC, LLC
13530 HIGHWAY 96
MILLPORT, AL
ZIP 35576
Phone: (205) 662-5784
Fax: (205) 662-5786



Authorized Official

Authorized Official NameDR. ROBERT E SWANSON DNP, CRNP
Authorized Official TitleMANAGING PARTNER
Authorized Official Phone(205) 662-5784

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
P16068MEDICARE UPIN (02)
541003936MEDICAID (05)AL
013936MEDICARE OSCAR/CERTIFICATION (06)AL

Other Providers at the same location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1508851486 ROBERT ENOCH SWANSON CRNP
Individual
Nurse Practitioner (Family)13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-5784
1790177459LAMAR PRIMARY CARE LLC
Organization
Health Maintenance Organization13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-5784
1063871184FMC MEDICAL CLINIC MILLPORT
Organization
Family Medicine13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-3207
1730593625MRS. HANNAH L LIVINGSTON CRNP
Individual
Nurse Practitioner13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-3207
1245233667 DAVID CLYDE CALL DO
Individual
Internal Medicine13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-3207
1902984032MILLPORT FAMILY PRACTICE CLINIC, LLC
Organization
Clinic/Center (Rural Health)13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-5784
1801975958MILLPORT INTERNAL MEDICINE
Organization
Clinic/Center (Medical Specialty)13530 HIGHWAY 96
MILLPORT, AL 35576
(205) 662-5784

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.