RIVER REGION FAMILY MEDICINE
NPI 1366565152
Clinic/Center - Rural Health in Wetumpka, AL

Q: What is Ivycreek Of Elmore LLC's NPI number?

The NPI number for Ivycreek Of Elmore LLC is 1366565152. It was assigned to this organization in the NPPES registry on April 9, 2007. The provider is doing business as River Region Family Medicine.

Q: What is Ivycreek Of Elmore LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since April 09, 2007CLIA 01D2186588 · Waiver

41 CAMBRIDGE CT, WETUMPKA, AL 36093(334) 567-3309(334) 567-3361 Get Directions Write a Review

NPPES record last updated: October 1, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About River Region Family Medicine NPPES

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

RIVER REGION FAMILY MEDICINE (NPI 1366565152) is a healthcare organization registered as a rural health in Wetumpka, Alabama and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through June 17, 2028 and lists Michael D Bruce, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366565152

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameIVYCREEK OF ELMORE LLC

Location Address41 CAMBRIDGE CTWetumpka, AL 36093-1261

Mailing AddressPo Box 130Wetumpka, AL 36092-0003 · (334) 567-4311 · Fax (334) 567-4312

Phone(334) 567-3309

Fax(334) 567-3361

Organization SubpartYes

Authorized OfficialMichael D BruceCeo · (334) 567-4311

Enumeration DateApril 9, 2007

Last NPPES UpdateOctober 1, 2012

✔ NPI 1366565152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

Also ListedPreferred Provider OrganizationTaxonomy 305R00000X · License 22736 (AL)

41 CAMBRIDGE CT, Wetumpka, AL 36093

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Other Names 1

Doing Business AsRiver Region Family Medicine

Other Identifiers 5

Medicare UPING99198AL

Medicare UPINP80604AL

Medicare PIN102G701614AL

Medicare UPINE41309AL

Medicaid540003434AL

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 01D2186588

River Region Family Medicine, LLC · Wetumpka, AL

Active · expires Jun 17, 2028

CLIA Number01D2186588

Laboratory TypePhysician Office

Certificate Effective DateJune 18, 2026

Certificate Expiration DateJune 17, 2028

Laboratory DirectorMartin A. Lyons

Laboratory Phone(334) 567-3309

Laboratory LocationRiver Region Family Medicine, LLC277 Huntress Street Suite 100, Wetumpka, AL 36092

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

DR. BRUCE LAMAR KENT M.D.

Family Medicine