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LAKE MARTIN FAMILY MEDICINE
NPI 1932130002
Clinic/Center - Rural Health in Dadeville, AL

Active since July 06, 2006CLIA 01D0920584 · Waiver
301 MARIARDEN RD, DADEVILLE, AL 36853(256) 825-7871(256) 825-5742 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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 holds a CLIA Waiver certificate valid through October 3, 2026 and lists Michael D Bruce, Ceo, as its authorized official.

NPPES Registry Identity

NPI1932130002
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameIVY CREEK OF TALLAPOOSA LLC
Location Address301 MARIARDEN RDDadeville, AL 36853-0129
Mailing AddressPo Box 129Dadeville, AL 36853-0129 · (256) 825-7871 · Fax (256) 825-5742
Phone(256) 825-7871
Fax(256) 825-5742
Organization SubpartNo
Authorized OfficialMichael D BruceCeo · (334) 567-4311
Enumeration DateJuly 6, 2006
Last NPPES UpdateApril 5, 2022
NPPES CertifiedApril 5, 2022
✔ NPI 1932130002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
301 MARIARDEN RD, Dadeville, AL 36853
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Other Names 1

Doing Business AsLake Martin Family Medicine

Other Identifiers 2

Medicaid540003420AL
Other01D0920584AL · Clia

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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, AL
Active · expires Oct 3, 2026
CLIA Number01D0920584
Laboratory TypeOther
Certificate Effective DateOctober 4, 2024
Certificate Expiration DateOctober 3, 2026
Laboratory DirectorRobert A. Schuster
Laboratory Phone(256) 825-7871
Laboratory LocationLake Martin Family Medicine301 Mariarden Road, Dadeville, AL 36853
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

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

KIMBERLY A ROBERTSON CRNP
Nurse Practitioner
301 MARIARDEN RD, SUITE D
DADEVILLE, AL 36853
Tallapoosa County (256) 825-3280
MS. DEBBIE S CLEVELAND CRNP
Nurse Practitioner (Family)
301 MARIARDEN RD
DADEVILLE, AL 36853
Tallapoosa County (256) 825-7871
BARBARA WILDER CRNP
Nurse Practitioner
301 MARIARDEN RD
DADEVILLE, AL 36853
Tallapoosa County (256) 825-7871
JOHN RAYMOND DURANT MD
General Practice
301 MARIARDEN RD, STE D
DADEVILLE, AL 36853
Tallapoosa County (256) 825-7871
ROBERT ALAN SCHUSTER MD
General Practice
301 MARIARDEN RD, STE D
DADEVILLE, AL 36853
Tallapoosa County (256) 825-7871
LAKE MARTIN PHARMACY
Pharmacy (Community/Retail Pharmacy)
301 MARIARDEN RD, SUITE A
DADEVILLE, AL 36853
Tallapoosa County (256) 825-7822
LAURA R DANIEL CRNP
Nurse Practitioner
301 MARIARDEN RD
DADEVILLE, AL 36853
Tallapoosa County (256) 825-7871
MR. ROBERT WILLIAM BARTEL MD
General Practice
301 MARIARDEN RD
DADEVILLE, AL 36853
Tallapoosa County (256) 825-7164

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 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.

Does Ivy Creek Of Tallapoosa LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D0920584) is associated with this NPI, valid through October 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ivy Creek Of Tallapoosa LLC accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama, Ambetter of Tennessee and Blue Cross and Blue Shield of Alabama and 1 other insurer 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 with the weekly NPPES data releases published by CMS.