| Alabama Family Medical Center, Llc | |
|
1718 Veterans Memorial Pkwy Suite C Tuscaloosa AL 35404 | |
| (205) 553-1900 | |
| (205) 553-4575 |
| Full Name | Alabama Family Medical Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1718 Veterans Memorial Pkwy, Tuscaloosa, Alabama |
| Authorized Official Name and Position | Ramesh B Peramsetty (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2055531900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alabama Family Medical Center, Llc 1718 Veterans Memorial Pkwy Suite C Tuscaloosa AL 35404-4708 Ph: (205) 553-1900 | Alabama Family Medical Center, Llc 1718 Veterans Memorial Pkwy Suite C Tuscaloosa AL 35404 Ph: (205) 553-1900 |
| NPI Number | 1245226489 |
|---|---|
| Provider Enumeration Date | 09/22/2005 |
| Last Update Date | 06/11/2018 |
| Medicare PECOS PAC ID | 3173567260 |
|---|---|
| Medicare Enrollment ID | O20050620000718 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245226489 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 24373 (Alabama) | Secondary |
| 207Q00000X | Family Medicine | 21446 (Alabama) | Primary |
| Provider Name | Douglas Shirley Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265537567 PECOS PAC ID: 3274424379 Enrollment ID: I20040319001545 |
| Provider Name | Dustin M Clary |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053400184 PECOS PAC ID: 8325001902 Enrollment ID: I20050121000217 |
| Provider Name | Ramesh B Peramsetty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730175969 PECOS PAC ID: 2264477355 Enrollment ID: I20050623000366 |
| Provider Name | Haritha V Guttikonda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912162504 PECOS PAC ID: 3678641842 Enrollment ID: I20081001000707 |
| Provider Name | Sumathi Puttu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649470717 PECOS PAC ID: 1850589862 Enrollment ID: I20101217000078 |
| Provider Name | Natasha R Horner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962711325 PECOS PAC ID: 8022295286 Enrollment ID: I20110615000772 |
| Provider Name | Sarah O Pate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003100694 PECOS PAC ID: 4486827193 Enrollment ID: I20111025000470 |
| Provider Name | Bridget M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902139322 PECOS PAC ID: 6901090075 Enrollment ID: I20200218001740 |
| Provider Name | Jinwoo Hur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306336011 PECOS PAC ID: 2062763485 Enrollment ID: I20200812003836 |
| Provider Name | Angelica L Weatherspoon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659037687 PECOS PAC ID: 4880072875 Enrollment ID: I20220603000056 |
| Provider Name | Gopi Yekolu |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114219854 PECOS PAC ID: 4880872175 Enrollment ID: I20220620001308 |
| Provider Name | Rachel Windle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700534120 PECOS PAC ID: 0345626032 Enrollment ID: I20221004001261 |
| Provider Name | Olivia Hope Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255729513 PECOS PAC ID: 8325348733 Enrollment ID: I20221209001117 |
| Provider Name | Sean D Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164198677 PECOS PAC ID: 6002205747 Enrollment ID: I20230117000845 |
| Provider Name | Kristen Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578074860 PECOS PAC ID: 3870920069 Enrollment ID: I20230209002415 |
| Provider Name | Sasank Raheel Peramsetty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225666175 PECOS PAC ID: 5294133740 Enrollment ID: I20230829000616 |
| Provider Name | Brenda Ferguson Sample |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295361368 PECOS PAC ID: 9436590627 Enrollment ID: I20240520000820 |
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