Ivy Creek Family Care Of Tallassee | |
2256 Gilmer Ave Tallassee AL 36078-7114 | |
(334) 283-2542 | |
Not Available |
Full Name | Ivy Creek Family Care Of Tallassee |
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Speciality | Clinic/Center |
Location | 2256 Gilmer Ave, Tallassee, Alabama |
Authorized Official Name and Position | Michael D Bruce (CEO) |
Authorized Official Contact | 3345674311 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ivy Creek Family Care Of Tallassee Po Box 130 Wetumpka AL 36092-0003 Ph: (334) 283-2542 | Ivy Creek Family Care Of Tallassee 2256 Gilmer Ave Tallassee AL 36078-7114 Ph: (334) 283-2542 |
NPI Number | 1558868323 |
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Provider Enumeration Date | 04/09/2018 |
Last Update Date | 04/05/2022 |
Medicare PECOS PAC ID | 8426075508 |
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Medicare Enrollment ID | O20051027001031 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558868323 | NPI | - | NPPES |
231148 | Medicaid | AL | |
01D2118261 | Other | AL | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Milton E Pointer |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1962466839 PECOS PAC ID: 9436051224 Enrollment ID: I20040122000759 |
Provider Name | Julie E Orender |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1043386063 PECOS PAC ID: 1153224621 Enrollment ID: I20040130000971 |
Provider Name | Mary A Barrow-llera |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1457372211 PECOS PAC ID: 8123916947 Enrollment ID: I20040304000951 |
Provider Name | Roger D Eiland |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1366478984 PECOS PAC ID: 4385533322 Enrollment ID: I20040315001103 |
Provider Name | Bruce A Kent |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1336229608 PECOS PAC ID: 6103896220 Enrollment ID: I20040727001340 |
Provider Name | Emelyn L Simpson |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1356352843 PECOS PAC ID: 7719949635 Enrollment ID: I20041102000590 |
Provider Name | Robert L England |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1639101702 PECOS PAC ID: 4284691171 Enrollment ID: I20041213000351 |
Provider Name | Rodney D Soto |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1588616890 PECOS PAC ID: 6608819545 Enrollment ID: I20050830000944 |
Provider Name | Lee G Aldrich |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1346260684 PECOS PAC ID: 9436183381 Enrollment ID: I20050921000286 |
Provider Name | Donald F Angle |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1184669137 PECOS PAC ID: 0749265551 Enrollment ID: I20060504000580 |
Provider Name | Muhammad Z Akbar |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801994983 PECOS PAC ID: 6800999046 Enrollment ID: I20070308000630 |
Provider Name | Djuana L Burns |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356372056 PECOS PAC ID: 5890893010 Enrollment ID: I20070611000646 |
Provider Name | David A Brannon |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1427186121 PECOS PAC ID: 4981703485 Enrollment ID: I20070625000454 |
Provider Name | Carolyn J Prokopyk |
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Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1093834855 PECOS PAC ID: 8224120068 Enrollment ID: I20070823000839 |
Provider Name | Bipin Kumar |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1710939376 PECOS PAC ID: 1254413768 Enrollment ID: I20080123000391 |
Provider Name | Urmil S Patel |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1336119015 PECOS PAC ID: 1759469448 Enrollment ID: I20080422000090 |
Provider Name | Gerald A Sweeney |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1003974551 PECOS PAC ID: 6103953096 Enrollment ID: I20100426000085 |
Provider Name | Marcial J Mendez |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1407870504 PECOS PAC ID: 0547245573 Enrollment ID: I20100505000014 |
Provider Name | Marvin Skinner |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1710941687 PECOS PAC ID: 2668480419 Enrollment ID: I20100812000033 |
Provider Name | Lindsey C Smitherman |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1679885032 PECOS PAC ID: 7810021284 Enrollment ID: I20100820000413 |
Provider Name | Melissa D Thompson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1548238272 PECOS PAC ID: 3476679515 Enrollment ID: I20100927001048 |
Provider Name | Jeana Ann Murphy |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811206386 PECOS PAC ID: 8123216645 Enrollment ID: I20101228000956 |
Provider Name | Janice M Seip |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1134167927 PECOS PAC ID: 0749479962 Enrollment ID: I20110104000601 |
Provider Name | Martin A Lyons |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356640379 PECOS PAC ID: 8325213226 Enrollment ID: I20111205000275 |
Provider Name | Sharon M Hamlin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790060341 PECOS PAC ID: 6305004847 Enrollment ID: I20120229000890 |
Provider Name | John Ryan Aldridge |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902150089 PECOS PAC ID: 7315198199 Enrollment ID: I20121105000452 |
Provider Name | Brandy T Laurenzi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609178714 PECOS PAC ID: 2668619792 Enrollment ID: I20130509000490 |
Provider Name | Matthew Motley |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1356754980 PECOS PAC ID: 2961622006 Enrollment ID: I20141013001325 |
Provider Name | Jeremy Taylor |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1770981334 PECOS PAC ID: 9638495955 Enrollment ID: I20150304001804 |
Provider Name | Elizabeth Rena Bacchus |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578952206 PECOS PAC ID: 9436479110 Enrollment ID: I20150520001319 |
Provider Name | Kailey Davis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093195729 PECOS PAC ID: 2466762141 Enrollment ID: I20151109001878 |
Provider Name | Leslie Pendergrass |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639541857 PECOS PAC ID: 1456661974 Enrollment ID: I20151112000584 |
Provider Name | Marlene L Wilson-lavalley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275919698 PECOS PAC ID: 9436454741 Enrollment ID: I20160812001570 |
Provider Name | Brandon Hemphill |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1376705160 PECOS PAC ID: 7618156076 Enrollment ID: I20161010001188 |
Provider Name | John W Amburgy |
---|---|
Provider Type | Practitioner - Neurosurgery |
Provider Identifiers | NPI Number: 1134485477 PECOS PAC ID: 3678723400 Enrollment ID: I20161027001429 |
Provider Name | Brian Heath Daniel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912359100 PECOS PAC ID: 0840578449 Enrollment ID: I20161102002160 |
Provider Name | Wesley J Jones |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1770027146 PECOS PAC ID: 0244514883 Enrollment ID: I20170228000532 |
Provider Name | Cathy Pitts |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508314865 PECOS PAC ID: 5991072076 Enrollment ID: I20170519001381 |
Provider Name | Sara A Piel |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1700311339 PECOS PAC ID: 2264701994 Enrollment ID: I20170711003415 |
Provider Name | Christina Elizabeth Allen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386173060 PECOS PAC ID: 7618240136 Enrollment ID: I20170906000412 |
Provider Name | Brandi I Criswell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144758756 PECOS PAC ID: 0840563987 Enrollment ID: I20170912000797 |
Provider Name | Jennifer Hobbs |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518481050 PECOS PAC ID: 0345509915 Enrollment ID: I20180108000841 |
Provider Name | Ashley N Huggins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225556350 PECOS PAC ID: 2769742865 Enrollment ID: I20180210000050 |
Provider Name | Brandon D Montz |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1053812412 PECOS PAC ID: 3072860899 Enrollment ID: I20180724003080 |
Provider Name | Cory Allen Luckie |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457708166 PECOS PAC ID: 5890071914 Enrollment ID: I20180927003316 |
Provider Name | Paul Jordan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1598706269 PECOS PAC ID: 8123293412 Enrollment ID: I20190729002632 |
Provider Name | Jessica Elizabeth Robbins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447725080 PECOS PAC ID: 1052648516 Enrollment ID: I20190807001700 |
Provider Name | Thomas D Bailey |
---|---|
Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1205815115 PECOS PAC ID: 1456242734 Enrollment ID: I20191008002288 |
Provider Name | Darcy P Blankenship |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1881176964 PECOS PAC ID: 8224467451 Enrollment ID: I20200408004561 |
Provider Name | Tanner Grant |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1902388002 PECOS PAC ID: 7719302157 Enrollment ID: I20200803001560 |
Provider Name | Kayla D Metz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689286262 PECOS PAC ID: 4486072105 Enrollment ID: I20200912000091 |
Provider Name | Emmanuel N Ozimba |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245233832 PECOS PAC ID: 8628010501 Enrollment ID: I20201228000265 |
Provider Name | Hali N Pearce |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1063973675 PECOS PAC ID: 7911235031 Enrollment ID: I20210128000697 |
Provider Name | Harrison M Fuqua |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972152791 PECOS PAC ID: 8527472778 Enrollment ID: I20210128002370 |
Provider Name | Tiffany Hethcox |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881282739 PECOS PAC ID: 6204241151 Enrollment ID: I20210226001352 |
Provider Name | Lyndsay Elizabeth Ewing |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982259065 PECOS PAC ID: 0840606430 Enrollment ID: I20210305000826 |
Provider Name | Jeffrey Bert Sloan |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1790724276 PECOS PAC ID: 0345146569 Enrollment ID: I20210310002480 |
Provider Name | Timothy James Littmann |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477050680 PECOS PAC ID: 1456752690 Enrollment ID: I20210625001584 |
Provider Name | Christopher W Daniel |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1073168191 PECOS PAC ID: 8325442254 Enrollment ID: I20210813001881 |
Provider Name | Christopher R Gehling |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730661828 PECOS PAC ID: 1759786627 Enrollment ID: I20210817000205 |
Provider Name | Luke Andrew Foshee |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497304299 PECOS PAC ID: 5597158071 Enrollment ID: I20220204000856 |
Provider Name | William Michael Tremlett |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912305418 PECOS PAC ID: 0244624096 Enrollment ID: I20220222000990 |
Provider Name | Katie Shiver Googe |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093327199 PECOS PAC ID: 9234523242 Enrollment ID: I20220308000449 |
Provider Name | Madeline Paige Hitt |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1376162966 PECOS PAC ID: 1153716873 Enrollment ID: I20220316001656 |
Provider Name | Kenneth Cory Guice |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1154950707 PECOS PAC ID: 6103256094 Enrollment ID: I20220329001530 |
Provider Name | Ryan Pollard |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225618382 PECOS PAC ID: 2860860855 Enrollment ID: I20221123000383 |
Provider Name | Alexandra Shade Gross |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356083968 PECOS PAC ID: 4789062662 Enrollment ID: I20221202002307 |
Community Medical Arts Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 875 Friendship Rd, Tallassee, AL 36078 Phone: 334-283-3111 Fax: 334-283-3156 | |
Tallassee Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 Herren Hill Rd, Tallassee, AL 36078 Phone: 334-283-3477 | |
Tallassee Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 80 Herren Hill Rd Ste A, Tallassee, AL 36078 Phone: 334-283-3844 Fax: 334-283-3735 | |
Michael W. Peaden Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 Herren Hill Rd, Tallassee, AL 36078 Phone: 334-283-3477 | |
Neptune Tech - Tallassee Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 Al Highway 229 S, Tallassee, AL 36078 Phone: 334-283-7230 | |
Thomas D Bianchi M.d.p.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 80 Herren Hill Rd, Suite E, Tallassee, AL 36078 Phone: 334-283-3862 Fax: 334-283-3871 |