LAKE MARTIN FAMILY MEDICINE
NPI 1932130002
Clinic/Center - Rural Health in Dadeville, AL
About Lake Martin Family Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE MARTIN FAMILY MEDICINE (NPI 1932130002) is a healthcare organization registered as a rural health in Dadeville, Alabama and active in the NPI registry since July 2006. The organization lists Michael D Bruce, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lake Martin Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
44Medicare enrollment records show 44 clinicians reassign Medicare billing to Lake Martin Family Medicine, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 12 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 10
Nearest to this location (20)
See all 44Birmingham, AL 35294
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 01D0920584
Lake Martin Family Medicine · Dadeville, ALFrequently 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 Tallapoosa LLC's NPI number?
The NPI number for Ivy Creek Of Tallapoosa LLC is 1932130002. It was assigned to this organization in the NPPES registry on July 6, 2006. The provider is doing business as Lake Martin Family Medicine.
Where is Ivy Creek Of Tallapoosa LLC located?
Ivy Creek Of Tallapoosa LLC is located at 301 Mariarden Rd, Dadeville, AL 36853. The listed phone number is (256) 825-7871.
What is Ivy Creek Of Tallapoosa 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 Tallapoosa LLC enrolled in Medicare?
Yes. Ivy Creek Of Tallapoosa LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ivy Creek Of Tallapoosa LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 44 clinicians in 10 Medicare specialties reassign their Medicare billing to Ivy Creek Of Tallapoosa 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 Family Practice (17), Nurse Practitioner (15) and Emergency Medicine (4). Of these, 8 practice at this address and 12 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Ivy Creek Of Tallapoosa LLC accept?
Health plans from Ambetter Health, Ambetter of Alabama, Ambetter of Tennessee, Blue Cross and Blue Shield of Alabama and UnitedHealthcare list Ivy Creek Of Tallapoosa 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 Tallapoosa LLC was last updated on April 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Lake Martin Family Medicine · NPI 1932130002
Rural Health organization in Dadeville, Alabama. Organization record, active in the CMS NPPES registry since July 6, 2006.
## Identity
- **NPI:** 1932130002 (Entity type: Organization)
- **Enumerated:** July 6, 2006
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Legal business name:** Ivy Creek Of Tallapoosa Llc
- **Organization subpart:** No
- **Authorized official:** Michael Bruce, CEO
## Practice location
- **Address:** 301 MARIARDEN RD, Dadeville, AL 36853-0129
- **Phone:** (256) 825-7871 · **Fax:** (256) 825-5742
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 44 clinicians in 10 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (17), Nurse Practitioner (15), Emergency Medicine (4); 8 practice at this address and 12 within 10 miles; [full list](https://npiprofile.com/npi/1932130002/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 5, 2022
- **Other identifiers:** Medicaid 540003420 (AL); Other 01D0920584 (AL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1932130002) · Data from the CMS NPPES public registry.