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EXTENDED FAMILY MEDICAL CLINIC
NPI 1720121395
Family Medicine in Mobile, AL

Active since February 14, 2007CLIA 01D1058526 · Waiver
108 N CATHERINE ST, SUITE A, MOBILE, AL 36604(251) 438-7170(251) 438-7173 Get Directions Write a Review

NPPES record last updated: March 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 19, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Extended Family Medical Clinic NPPES

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

EXTENDED FAMILY MEDICAL CLINIC (NPI 1720121395) is a healthcare organization registered as a family medicine in Mobile, Alabama and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through September 6, 2026 and lists Angelia Deniese Blackmon, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1720121395
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEXTENDED FAMILY MEDICAL CLINIC
Location Address108 N CATHERINE ST, SUITE AMobile, AL 36604-1304
Mailing Address108 N Catherine St, Suite AMobile, AL 36604-1304 · (251) 438-7170 · Fax (251) 438-7173
Phone(251) 438-7170
Fax(251) 438-7173
Organization SubpartNo
Authorized OfficialAngelia Deniese BlackmonMedical Director · (251) 438-7170
Enumeration DateFebruary 14, 2007
Last NPPES UpdateMarch 19, 20252 updates tracked since enumeration
NPPES CertifiedMarch 19, 2025
✔ NPI 1720121395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/CenterTaxonomy 261Q00000X · License 1-073404 (AL)
108 N CATHERINE ST, Mobile, AL 36604
Open in Google Maps ↗

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 01D1058526

Extended Family Care Medical Clinic · Mobile, AL
Active · expires Sep 6, 2026
CLIA Number01D1058526
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 7, 2024
Certificate Expiration DateSeptember 6, 2026
Laboratory DirectorAngelia D. Blackmon
Laboratory Phone(251) 438-7170
Laboratory LocationExtended Family Care Medical Clinic108 North Catherine Street Suite A, Mobile, AL 36604
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Extended Family Medical Clinic's NPI number?

The NPI number for Extended Family Medical Clinic is 1720121395. It was assigned to this organization in the NPPES registry on February 14, 2007.

Where is Extended Family Medical Clinic located?

Extended Family Medical Clinic is located at 108 N Catherine St Suite A, Mobile, AL 36604. The listed phone number is (251) 438-7170.

What is Extended Family Medical Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Extended Family Medical Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D1058526) is associated with this NPI, valid through September 6, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Extended Family Medical Clinic was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.