| Enterprise Children's Center & Family Medicine | |
|
105 E Watts St Enterprise AL 36330-2511 | |
| (334) 393-5437 | |
| (334) 489-4438 |
| Full Name | Enterprise Children's Center & Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 105 E Watts St, Enterprise, Alabama |
| Authorized Official Name and Position | John A Little (CEO) |
| Authorized Official Contact | 3346706726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enterprise Children's Center & Family Medicine 1414 Elba Hwy Troy AL 36079-6020 Ph: (334) 670-6726 | Enterprise Children's Center & Family Medicine 105 E Watts St Enterprise AL 36330-2511 Ph: (334) 393-5437 |
| NPI Number | 1891856134 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 02/21/2019 |
| Medicare PECOS PAC ID | 8123009057 |
|---|---|
| Medicare Enrollment ID | O20040526001591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891856134 | NPI | - | NPPES |
| 630006018 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Griffith G Walters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801829643 PECOS PAC ID: 3375531213 Enrollment ID: I20040430001369 |
| Provider Name | David E Runyon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720098809 PECOS PAC ID: 5890769897 Enrollment ID: I20040825000326 |
| Provider Name | Adolfo Robledo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639117534 PECOS PAC ID: 4082675541 Enrollment ID: I20041019001081 |
| Provider Name | Joseph H Sewell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568430056 PECOS PAC ID: 7416905120 Enrollment ID: I20050110000735 |
| Provider Name | Robert Alan Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154508380 PECOS PAC ID: 4587618079 Enrollment ID: I20050308000751 |
| Provider Name | Ben A Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922018183 PECOS PAC ID: 1153210893 Enrollment ID: I20051101000413 |
| Provider Name | Tania C Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598768145 PECOS PAC ID: 5496725913 Enrollment ID: I20060117000844 |
| Provider Name | Robert L Gilliam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164432308 PECOS PAC ID: 2769498831 Enrollment ID: I20060227000463 |
| Provider Name | David H Arnold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891794822 PECOS PAC ID: 3375547284 Enrollment ID: I20060907000515 |
| Provider Name | Donette L Bish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346259314 PECOS PAC ID: 6709850977 Enrollment ID: I20061220000459 |
| Provider Name | Carol W Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598775744 PECOS PAC ID: 2264501600 Enrollment ID: I20080527000387 |
| Provider Name | Richard Bendinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558321786 PECOS PAC ID: 1355344425 Enrollment ID: I20100812000117 |
| Provider Name | Nasser P Samuy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710118898 PECOS PAC ID: 5496892895 Enrollment ID: I20120807000906 |
| Provider Name | Brandi B Dowling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811251010 PECOS PAC ID: 9335396852 Enrollment ID: I20120905000565 |
| Provider Name | Steven E Norman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215901517 PECOS PAC ID: 6507753837 Enrollment ID: I20130226000055 |
| Provider Name | Jefferson Guy Alexander Edgington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619391265 PECOS PAC ID: 4082845979 Enrollment ID: I20140317002052 |
| Provider Name | Haley G Clements |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295143733 PECOS PAC ID: 3779704671 Enrollment ID: I20141017001201 |
| Provider Name | Cynthia N Milstead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033240601 PECOS PAC ID: 4183706880 Enrollment ID: I20151210000860 |
| Provider Name | Norma Lynn Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063879054 PECOS PAC ID: 0446556146 Enrollment ID: I20160307000938 |
| Provider Name | Tracey L Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306247796 PECOS PAC ID: 4284926254 Enrollment ID: I20160712001663 |
| Provider Name | Joanna Nicole Kallendorf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295278653 PECOS PAC ID: 5597046011 Enrollment ID: I20161221001082 |
| Provider Name | Millicent R Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063956233 PECOS PAC ID: 7214210160 Enrollment ID: I20170220001318 |
| Provider Name | Victoria Brooke Darts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427561976 PECOS PAC ID: 7214297381 Enrollment ID: I20180209001531 |
| Provider Name | Jessica E Poitevint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063925626 PECOS PAC ID: 7315201407 Enrollment ID: I20180425001058 |
| Provider Name | Jamie L Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184110850 PECOS PAC ID: 0749530004 Enrollment ID: I20180906002740 |
| Provider Name | Christie Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528609146 PECOS PAC ID: 5496180721 Enrollment ID: I20200115000906 |
| Provider Name | Jill Goings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942582242 PECOS PAC ID: 1658544754 Enrollment ID: I20200226002499 |
| Provider Name | Dana Baldo-downs Wade |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730568171 PECOS PAC ID: 7113355728 Enrollment ID: I20200313001289 |
| Provider Name | Carrie Little Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639793334 PECOS PAC ID: 1355769761 Enrollment ID: I20200917000938 |
| Provider Name | Morgan Williams Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508531757 PECOS PAC ID: 5799183349 Enrollment ID: I20211012001426 |
| Provider Name | Bernadette S Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174962971 PECOS PAC ID: 3577797265 Enrollment ID: I20220815000755 |
| Provider Name | Mary Ella Spivey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134805690 PECOS PAC ID: 4183070055 Enrollment ID: I20231029000138 |
Professional Medical Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 E Brunson St, Suite 200, Enterprise, AL 36330 Phone: 334-393-3686 Fax: 334-347-4906 | |
By His Grace Primary Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 806 Glover Ave Ste A, Enterprise, AL 36330 Phone: 334-475-2680 Fax: 334-475-2681 | |
David H. Hayes, M.d., L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 806 Glover Ave, Suite B, Enterprise, AL 36330 Phone: 334-347-0991 Fax: 334-347-1805 | |
New Horizons Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1018 Rucker Blvd Ste A, Enterprise, AL 36330 Phone: 334-347-4343 Fax: 334-393-9611 | |
Hillside Family Practice Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1008 Boll Weevil Cir, Suite B, Enterprise, AL 36330 Phone: 334-475-2067 | |
Fast Pace Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1026 Boll Weevil Circle, Enterprise, AL 36330 Phone: 931-253-1110 | |
Stephen R Brandt Md Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 E Watts St, Enterprise, AL 36330 Phone: 334-393-5437 Fax: 334-393-4185 |