FORT PAYNE PEDIATRICS LLC (NPI# 1033477393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033477393 |
| Entity Type | Organization |
| Organization Name | FORT PAYNE PEDIATRICS LLC |
| Other Organization Name | FT PAYNE PEDIATRICS,LLC |
| Practice Address |
1906 Glenn Blvd Sw Ste 100a Fort Payne AL 35968-3546 |
| Practice Telephone | 2569975900 |
| Mailing Telephone | 2569975900 |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2014-03-31 |
| Authorized Official Name | PETER STROGOV (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 2569975900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 30426 | AL | Allopathic & Osteopathic Physicians |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-075895 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-087445 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
01-8910 | AL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 139385 | 05 |
| Other Name | Type Code |
|---|---|
| Ft Payne Pediatrics,LLC | Other Name - Individual/Organization |
| Street Address |
1906 GLENN BLVD SW STE 100A |
| City | FORT PAYNE |
| State | AL |
| Zip Code | 35968-3546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710038906 | Tonya Leigh Moses | Nurse Practitioner | 1906 Glenn Blvd Sw Ste 100a, Fort Payne, AL 35968-3546 | 2007-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417382623 | Lori Land Camp | Pharmacist | 101 Cracker Barrel Row, Ft Payne, AL 35968 | 2013-09-06 |
| 1841424959 | Ashley Renee Cole | Emergency Medicine | 590 Medical Center Dr, Fort Payne, AL 35968 | 2009-05-05 |
| 1871758938 | Michael Steven Digby | Dermatology | 1403 Old Water Works Rd Sw, Fort Payne, AL 35968 | 2008-07-28 |
| 1356516611 | Robyn Reesman, O.d.,inc. | Optometrist | 2001 Glenn Blvd. Sw, Fort Payne, AL 35968 | 2008-04-28 |
| 1124219902 | Rebecca Burns Ingram | Occupational Therapist | 2804 Greenhill Blvd Nw Ste 102, Fort Payne, AL 35968 | 2007-08-06 |
| 1467657957 | Palmer Orthopaedic & Sports Medicine, PC | Orthopaedic Surgery | 315 Medical Center Dr. Sw, Fort Payne, AL 35968 | 2007-06-15 |
| 1225171309 | Dekalb County Health Dept Offsite Epsdt | Public Health or Welfare | 2401 Calvin Dr, S.w., Ft. Payne, AL 35968 | 2007-02-15 |
| 1376612648 | American Hospice -- Fort Payne | Hospice Care, Community Based | 103 3rd Street North West, Suite 202, Fort Payne, AL 35968 | 2006-11-08 |
| 1316978588 | Bhc-palmer Orthopaedics and Sports Medicine | Specialist | 315 Medical Park, Fort Payne, AL 35968 | 2006-07-06 |
| 1487694782 | Fort Payne Hospital Corporation | Hospitalist | 200 Medical Center Dr., Fort Payne, AL 35968 | 2006-06-07 |
| Find all providers in zip 35968 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457411043 | Isbell Medical Group, P.C. | Clinic/Center | 550 Medical Center Dr Sw, Fort Payne, AL 35968-3418 | 2006-12-12 |
| 1184679938 | Fort Payne Rhc Corp | Clinic/Center | 415 Medical Center Dr Sw, Fort Payne, AL 35968-3421 | 2006-05-23 |
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|---|---|---|---|---|
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| 1952952541 | Pediatric Associates of Alexander City PC | Clinic/Center | 21 Coosa County Road 50, Kellyton, AL 35089-1900 | 2019-09-25 |
| 1205309044 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 184 William E Hill Drive Ste C, Carrollton, AL 35447 | 2019-01-04 |
| 1487123915 | Physicians Care of Camden LLC | Clinic/Center | 24b Camden Byp, Camden, AL 36726-1770 | 2018-11-14 |
| 1336634666 | Central Pediatrics of Somerville LLC | Clinic/Center | 3609 Highway 67 S, Somerville, AL 35670 | 2018-06-28 |
| 1578060349 | Ivy Creek of Elmore, LLC | Clinic/Center | 4412 Hogan Rd, Deatsville, AL 36022-3400 | 2018-04-09 |
| 1568915106 | Physicians Care of Grove Hill LLC | Clinic/Center | 127 Clark St Ste C&d, Grove Hill, AL 36451-3050 | 2016-08-01 |
| 1205294428 | Red Bay Hospital Outpatient Clinics LLC | Clinic/Center | 14490 County Line Road, Suite A, Muscle Shoals, AL 35661 | 2016-02-02 |
| 1972985968 | Athens Limestone Pediatric Center LLC | Clinic/Center | 101 Fitness Way Ste 2100, Athens, AL 35611-2494 | 2015-06-25 |
| 1396125258 | D W Mcmillan Memorial Hospital | Clinic/Center | 1674 Cleveland Ave, Castleberry, AL 36432 | 2015-06-05 |
| Find all providers with the same taxonomy | ||||
| City | FORT PAYNE |
| Zip Code | 35968 |
Please comment or provide details below to improve the information on FORT PAYNE PEDIATRICS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.