Lake Martin Family Medicine | |
301 Mariarden Rd Dadeville AL 36853-0129 | |
(256) 825-7871 | |
(256) 825-5742 |
Full Name | Lake Martin Family Medicine |
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Speciality | Clinic/Center |
Location | 301 Mariarden Rd, Dadeville, 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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Lake Martin Family Medicine Po Box 129 Dadeville AL 36853-0129 Ph: (256) 825-7871 | Lake Martin Family Medicine 301 Mariarden Rd Dadeville AL 36853-0129 Ph: (256) 825-7871 |
NPI Number | 1932130002 |
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Provider Enumeration Date | 07/06/2006 |
Last Update Date | 04/05/2022 |
Medicare PECOS PAC ID | 8123938719 |
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Medicare Enrollment ID | O20031229000288 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932130002 | NPI | - | NPPES |
540003420 | Medicaid | AL | |
01D0920584 | Other | AL | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | John R Durant |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790717858 PECOS PAC ID: 7810800091 Enrollment ID: I20031112000675 |
Provider Name | Charles E. Singleton |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1275623639 PECOS PAC ID: 3173410958 Enrollment ID: I20040304000669 |
Provider Name | Roger D Eiland |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1366478984 PECOS PAC ID: 4385533322 Enrollment ID: I20040315001103 |
Provider Name | Robert L England |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1639101702 PECOS PAC ID: 4284691171 Enrollment ID: I20041213000351 |
Provider Name | Rodney D Soto |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1588616890 PECOS PAC ID: 6608819545 Enrollment ID: I20050830000944 |
Provider Name | Donald F Angle |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1184669137 PECOS PAC ID: 0749265551 Enrollment ID: I20060504000580 |
Provider Name | Debbie S Cleveland |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164407656 PECOS PAC ID: 8628171774 Enrollment ID: I20070312000202 |
Provider Name | Barbara F Wilder |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598797656 PECOS PAC ID: 5597836643 Enrollment ID: I20080617000259 |
Provider Name | Laura R Daniel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952634248 PECOS PAC ID: 3375686520 Enrollment ID: I20100210000256 |
Provider Name | Jeffrey D. Voreis |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144239450 PECOS PAC ID: 4688705494 Enrollment ID: I20100623000184 |
Provider Name | Robert Alan Schuster |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1871525931 PECOS PAC ID: 1951378934 Enrollment ID: I20100818000768 |
Provider Name | Robert W Bartel |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1164538203 PECOS PAC ID: 5890886766 Enrollment ID: I20100824000012 |
Provider Name | Kimberly Ann Robertson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114929742 PECOS PAC ID: 9234125477 Enrollment ID: I20110407000533 |
Provider Name | Sharon M Hamlin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790060341 PECOS PAC ID: 6305004847 Enrollment ID: I20120229000890 |
Provider Name | William D Talley |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053523456 PECOS PAC ID: 9739331737 Enrollment ID: I20121219000442 |
Provider Name | Sabrina Davis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376889063 PECOS PAC ID: 7113172826 Enrollment ID: I20130304000241 |
Provider Name | Andrea Marie Stewart-adams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144221979 PECOS PAC ID: 4082869532 Enrollment ID: I20160309003005 |
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 | Brian Heath Daniel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912359100 PECOS PAC ID: 0840578449 Enrollment ID: I20161102002160 |
Provider Name | Cathy Pitts |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508314865 PECOS PAC ID: 5991072076 Enrollment ID: I20170519001381 |
Provider Name | Rebecca J Allen-jones |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881118453 PECOS PAC ID: 3173878402 Enrollment ID: I20180609000024 |
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 | Darcy P Blankenship |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1881176964 PECOS PAC ID: 8224467451 Enrollment ID: I20200408004561 |
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 | Jeffrey Bert Sloan |
---|---|
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 | April Dailey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407432347 PECOS PAC ID: 7416359468 Enrollment ID: I20210713002329 |
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 | Abby Newman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922644178 PECOS PAC ID: 9931597325 Enrollment ID: I20211104001811 |
Provider Name | Anna Collins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073182127 PECOS PAC ID: 1557750445 Enrollment ID: I20211115002488 |
Provider Name | Khalid Ali |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760597561 PECOS PAC ID: 4981094729 Enrollment ID: I20211209000997 |
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 | 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 | Michael L Bevels |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093595746 PECOS PAC ID: 2860469848 Enrollment ID: I20240319001996 |
Medical Park Family Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1034 S Tallassee St, Dadeville, AL 36853 Phone: 256-825-9900 Fax: 256-825-6620 | |
Ivy Creek Of Tallapoosa, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5958 Highway 49 S Unit K, Dadeville, AL 36853 Phone: 256-825-7871 | |
Ivy Creek Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5958 Highway 49 S Unit K, Dadeville, AL 36853 Phone: 256-825-7821 | |
Stillwaters Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2129 Moonbrook Dr, Dadeville, AL 36853 Phone: 334-514-3848 Fax: 334-514-3686 | |
Bartel Family Medicine Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 139 E Lafayette St, Dadeville, AL 36853 Phone: 256-825-8211 Fax: 256-825-0999 |