IVY CREEK OF ELMORE, LLC
NPI 1578060349
Clinic/Center - Rural Health in Deatsville, AL
About Ivy Creek Of Elmore, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IVY CREEK OF ELMORE, LLC (NPI 1578060349), doing business as Ivy Creek Family Care Of Holtville, is a healthcare organization registered as a rural health in Deatsville, Alabama and active in the NPI registry since April 2018. The organization lists Jade Lane, Credentialing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ivy Creek Of Elmore, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
181Medicare enrollment records show 181 clinicians reassign Medicare billing to Ivy Creek Of Elmore, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 16
Nearest to this location (20)
See all 181Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Ivy Creek Of Elmore, LLC's NPI number?
The NPI number for Ivy Creek Of Elmore, LLC is 1578060349. It was assigned to this organization in the NPPES registry on April 9, 2018. The provider is doing business as Ivy Creek Family Care Of Holtville.
Where is Ivy Creek Of Elmore, LLC located?
Ivy Creek Of Elmore, LLC is located at 4412 Hogan Rd, Deatsville, AL 36022. The listed phone number is (334) 514-4851.
What is Ivy Creek Of Elmore, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Ivy Creek Of Elmore, LLC enrolled in Medicare?
Yes. Ivy Creek Of Elmore, LLC is registered in the Medicare PECOS enrollment system.
When is Ivy Creek Of Elmore, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Alabama, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Ivy Creek Of Elmore, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 181 clinicians in 16 Medicare specialties reassign their Medicare billing to Ivy Creek Of Elmore, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (106), Family Practice (22) and Nurse Practitioner (17). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Ivy Creek Of Elmore, LLC accept?
Health plans from Ambetter Health, Ambetter of Alabama and Ambetter of Tennessee list Ivy Creek Of Elmore, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ivy Creek Of Elmore, LLC was last updated on March 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Ivy Creek Of Elmore, Llc · NPI 1578060349
Rural Health organization in Deatsville, Alabama. Organization record, active in the CMS NPPES registry since April 9, 2018.
## Identity
- **NPI:** 1578060349 (Entity type: Organization)
- **Enumerated:** April 9, 2018
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Also known as:** IVY CREEK FAMILY CARE OF HOLTVILLE (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Jade Lane, CREDENTIALING MANAGER
## Practice location
- **Address:** 4412 HOGAN RD, Deatsville, AL 36022-3400
- **Phone:** (334) 514-4851 · **Fax:** (334) 543-4854
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Alabama, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 181 clinicians in 16 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (106), Family Practice (22), Nurse Practitioner (17); 1 practice at this address and 2 within 10 miles; [full list](https://npiprofile.com/npi/1578060349/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 20, 2025
- **Other identifiers:** Other 1608 (AL); Other 01D2153925 (AL); Medicaid 231138 (AL); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1578060349) · Data from the CMS NPPES public registry.