| Crestwood Physician Services, Llc | |
|
4810 Whitesport Cir Sw Suite 201 Huntsville AL 35801-7419 | |
| (256) 429-5248 | |
| (256) 429-5247 |
| Full Name | Crestwood Physician Services, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4810 Whitesport Cir Sw, Huntsville, Alabama |
| Authorized Official Name and Position | James Patrick Wright (VP PHYSICIAN BUSINESS SERVICES) |
| Authorized Official Contact | 6157781502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestwood Physician Services, Llc Po Box 689022 Franklin TN 37068-9022 Ph: () - | Crestwood Physician Services, Llc 4810 Whitesport Cir Sw Suite 201 Huntsville AL 35801-7419 Ph: (256) 429-5248 |
| NPI Number | 1154622520 |
|---|---|
| Provider Enumeration Date | 11/16/2010 |
| Last Update Date | 01/09/2020 |
| Medicare PECOS PAC ID | 3476735648 |
|---|---|
| Medicare Enrollment ID | O20110309000303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154622520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jenny C Chapman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699709709 PECOS PAC ID: 4486638251 Enrollment ID: I20040617001055 |
| Provider Name | Lona Hope Haskell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023072642 PECOS PAC ID: 2668458217 Enrollment ID: I20040701000327 |
| Provider Name | Bhavna Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619921822 PECOS PAC ID: 1052342573 Enrollment ID: I20050824001062 |
| Provider Name | Kenneth J Batchelor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205954799 PECOS PAC ID: 1557395589 Enrollment ID: I20050920000639 |
| Provider Name | Valerie L Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073531661 PECOS PAC ID: 8123101375 Enrollment ID: I20080211000511 |
| Provider Name | David A Mcmillion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134339880 PECOS PAC ID: 1456403021 Enrollment ID: I20090713000046 |
| Provider Name | Mary E Barry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104894963 PECOS PAC ID: 5890703102 Enrollment ID: I20100623000136 |
| Provider Name | Jeffrey G. Garber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174504740 PECOS PAC ID: 4981735982 Enrollment ID: I20100707000387 |
| Provider Name | Charles D. Coffey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093701849 PECOS PAC ID: 7416083464 Enrollment ID: I20100824000131 |
| Provider Name | Ann S Chu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982788519 PECOS PAC ID: 7618997685 Enrollment ID: I20100929000899 |
| Provider Name | John E Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275831703 PECOS PAC ID: 2961686654 Enrollment ID: I20110404000709 |
| Provider Name | Smita S Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063454817 PECOS PAC ID: 4981660578 Enrollment ID: I20110727000120 |
| Provider Name | Carisa F Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356689129 PECOS PAC ID: 8325292543 Enrollment ID: I20130215000332 |
| Provider Name | Betsy M Osborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821412396 PECOS PAC ID: 0547493470 Enrollment ID: I20140430001462 |
| Provider Name | Abigail L Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912339516 PECOS PAC ID: 9830402106 Enrollment ID: I20150715001038 |
| Provider Name | Janice Lewis-thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114977931 PECOS PAC ID: 8022194794 Enrollment ID: I20160111001752 |
| Provider Name | Mahmood M Alasmi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215120126 PECOS PAC ID: 3375607450 Enrollment ID: I20160303002012 |
| Provider Name | Kristie L Quattlebaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609231885 PECOS PAC ID: 0042517575 Enrollment ID: I20160329001983 |
| Provider Name | Bernard Anthony Kurecki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487604336 PECOS PAC ID: 2769552116 Enrollment ID: I20160801001718 |
| Provider Name | Yari Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144398678 PECOS PAC ID: 3577525658 Enrollment ID: I20160804002306 |
| Provider Name | Jose F Pace |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568867042 PECOS PAC ID: 4284905902 Enrollment ID: I20170728002927 |
| Provider Name | Nicholas D Prylinski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275979858 PECOS PAC ID: 6507082179 Enrollment ID: I20170828003828 |
| Provider Name | Tiaya A Lang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467978221 PECOS PAC ID: 7214285865 Enrollment ID: I20180730002936 |
| Provider Name | Kim A Driggers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407332232 PECOS PAC ID: 5698028413 Enrollment ID: I20181025000040 |
| Provider Name | Angela M Durham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699862474 PECOS PAC ID: 6204950033 Enrollment ID: I20181121000674 |
| Provider Name | Rodney L Holladay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881679488 PECOS PAC ID: 9335031129 Enrollment ID: I20190619002014 |
| Provider Name | Satyabrata Chatterjee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437143260 PECOS PAC ID: 6305835505 Enrollment ID: I20200507000698 |
| Provider Name | Blair Chance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992152607 PECOS PAC ID: 1759679095 Enrollment ID: I20200618002227 |
| Provider Name | Kaitlyn Wendolowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033728100 PECOS PAC ID: 4981020914 Enrollment ID: I20200820001692 |
| Provider Name | Hussien Farrag |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811070923 PECOS PAC ID: 3476613431 Enrollment ID: I20210914000675 |
| Provider Name | Erin K Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366100059 PECOS PAC ID: 3870987522 Enrollment ID: I20220223002245 |
| Provider Name | Shaista Qureshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770681405 PECOS PAC ID: 1759388622 Enrollment ID: I20220329000337 |
| Provider Name | Jason Fultz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164083093 PECOS PAC ID: 5294060422 Enrollment ID: I20220711000536 |
| Provider Name | Jastin J Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689136681 PECOS PAC ID: 8426432816 Enrollment ID: I20220902001988 |
| Provider Name | Taquina Hambrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437891074 PECOS PAC ID: 9638545965 Enrollment ID: I20221012000101 |
| Provider Name | Kerianne M Donham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700533882 PECOS PAC ID: 8628444825 Enrollment ID: I20221012003430 |
| Provider Name | Diane Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326284217 PECOS PAC ID: 5799904348 Enrollment ID: I20221103001938 |
| Provider Name | Emily Michelle Stephenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205495967 PECOS PAC ID: 1456721935 Enrollment ID: I20221227000687 |
| Provider Name | Brittany Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780320770 PECOS PAC ID: 9032580741 Enrollment ID: I20230117001297 |
| Provider Name | Wanda Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114674595 PECOS PAC ID: 9133590714 Enrollment ID: I20230118000922 |
| Provider Name | Caroline Mackey Mauldin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457597080 PECOS PAC ID: 7517338080 Enrollment ID: I20230119001792 |
| Provider Name | Casey Bodkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881306769 PECOS PAC ID: 8820469240 Enrollment ID: I20230123002523 |
| Provider Name | Daniel Scott Krautter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306401757 PECOS PAC ID: 6406182567 Enrollment ID: I20230711002085 |
| Provider Name | Lyle Gary Bohlman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265420301 PECOS PAC ID: 1759337157 Enrollment ID: I20230807001879 |
| Provider Name | Donna Montgomery Bogus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184760159 PECOS PAC ID: 0941664981 Enrollment ID: I20230911000672 |
| Provider Name | Samuel Waling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053774018 PECOS PAC ID: 5991070013 Enrollment ID: I20231227001260 |
| Provider Name | Sarah Elizabeth Waling |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881057792 PECOS PAC ID: 1850665126 Enrollment ID: I20240103003438 |
| Provider Name | Jennifer Sheridan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730947250 PECOS PAC ID: 2860830239 Enrollment ID: I20240404000049 |
Bptcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 311 Longwood Dr, Sw, Huntsville, AL 35801 Phone: 256-534-5946 Fax: 256-534-3041 | |
Inspirational Counseling Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4100 Market St Ste 100, Huntsville, AL 35808 Phone: 256-210-4925 | |
Gleneagles Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1102 Gleneagles Dr Sw, Huntsville, AL 35801 Phone: 256-881-5880 Fax: 256-883-3280 | |
Magnolia Primary Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4245 Balmoral Dr Sw Ste 102, Huntsville, AL 35801 Phone: 256-203-6676 Fax: 833-979-0980 | |
Five Points Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 Pratt Ave Ne, Huntsville, AL 35801 Phone: 256-714-3363 | |
Davis Medical Group, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7850 Memorial Pkwy Sw, Huntsville, AL 35802 Phone: 256-882-0132 Fax: 256-882-1461 | |
Crestani Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2745 Bob Wallace Ave Sw, Suite D, Huntsville, AL 35805 Phone: 256-534-1323 Fax: 256-534-1780 |