Ft Payne Careplus, Llc | |
3000 Gault Ave North Ft Payne AL 35967 | |
(256) 697-1012 | |
Not Available |
Full Name | Ft Payne Careplus, Llc |
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Speciality | Clinic/Center |
Location | 3000 Gault Ave North, Ft Payne, Alabama |
Authorized Official Name and Position | Angela Vaughn (ADMINISTRATOR) |
Authorized Official Contact | 2563104941 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ft Payne Careplus, Llc 3000 Gault Ave North Ft Payne AL 35967 Ph: (256) 697-1012 | Ft Payne Careplus, Llc 3000 Gault Ave North Ft Payne AL 35967 Ph: (256) 697-1012 |
NPI Number | 1073086922 |
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Provider Enumeration Date | 01/03/2019 |
Last Update Date | 01/03/2019 |
Medicare PECOS PAC ID | 6709127392 |
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Medicare Enrollment ID | O20190409000639 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073086922 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Summer M Phelps |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689890337 PECOS PAC ID: 6608882881 Enrollment ID: I20060224000432 |
Provider Name | Jonathan C Hood |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467471003 PECOS PAC ID: 5193734614 Enrollment ID: I20060411000799 |
Provider Name | Tonya L Moses |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710038906 PECOS PAC ID: 1254419880 Enrollment ID: I20080423000360 |
Provider Name | Josiah C Daily |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1285837377 PECOS PAC ID: 6800931056 Enrollment ID: I20100226000797 |
Provider Name | Elizabeth D Cole |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265470900 PECOS PAC ID: 3274529201 Enrollment ID: I20130806000681 |
Provider Name | Corey W Gilliland |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1043335136 PECOS PAC ID: 3870494776 Enrollment ID: I20130925000839 |
Provider Name | Allison Shea Wright Glassco |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447701560 PECOS PAC ID: 9830474402 Enrollment ID: I20170322000472 |
Provider Name | Bethany Nailor |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013678713 PECOS PAC ID: 6103210802 Enrollment ID: I20220223000312 |