NPI Record of AMERICAN FAMILY CARE, INC. NPI 1497858948

General Practice in Gardendale, AL

Complete NPI Record

Field Name Value Definition
NPI1497858948The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. 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 (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameAMERICAN FAMILY CARE, INC.The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address3700 CAHABA BEACH RDThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NameBIRMINGHAMThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameALThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code352425225The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number0540389022The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number2054212109The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address919 ODUM ROADThe first line 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 Business Practice Location Address City NameGARDENDALEThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameALThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code350713600The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number2056316834The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2056310273The fax number associated with the location address of the provider being identified.
Provider Enumeration Date9/7/2006The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date6/12/2020The date that a record was last updated or changed.
Authorized Official Last NameJOHANSENThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameRANDYThe first name of the authorized official.
Authorized Official Title or PositionPRESIDENTThe title or position of the authorized official.
Authorized Official Telephone Number2054212101The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1208D00000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 1CA6570Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 101Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1AL
Other Provider Identifier Issuer 1RAILROAD MEDICARE
Is Organization SubpartY
Parent Organization LBNAMERICAN FAMILY CARE, INC.
Parent Organization TINUNAVAIL
Authorized Official Name Prefix TextMR.
Healthcare Provider Taxonomy Group 1193200000X MULTI-SPECIALTY GROUP
NPI Certification Date6/12/2020