IVY CREEK OF TALLAPOOSA


Address: 201 Mariarden Rd, Dadeville, AL 36853-6244
Phone: 2568257821

IVY CREEK OF TALLAPOOSA (NPI# 1811169857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811169857
Entity Type Organization
Organization Name IVY CREEK OF TALLAPOOSA
Other Organization Name LAKE MARTIN COMMUNITY HOSPITAL
Practice Address 201 Mariarden Rd
Dadeville
AL 36853-6244
Mailing Address 201 Mariarden Road
Dadeville
AL 36853-6244
Practice Telephone 2568257821
Enumeration Date 2008-03-31
Last Update Date 2008-03-31
Authorized Official Name MRS. CAROLINE MORRIS (BUSINESS OFFICE MANAGER)
Authorized Official Telephone 2568257821
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 146N00000X Emergency Medical Technician, Basic 0712 AL Emergency Medical Service Providers

Other Provider/Organization Names

Other Name Type Code
LAKE MARTIN COMMUNITY HOSPITAL Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1194278614 Ivy Creek of Tallapoosa Clinic/Center 301 Mariarden Rd, Dadeville, AL 36853-6254 2016-08-02
1720273303 Ivy Creek of Tallapoosa General Acute Care Hospital 201 Mariarden Rd, Dadeville, AL 36853-6244 2007-09-07

Office Location

Street Address 201 MARIARDEN RD
City DADEVILLE
State AL
Zip Code 36853-6244

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255303921 Tallapoosa Ems, LLC Ambulance 201 Mariarden Rd, Dadeville, AL 36853-6244 2006-02-06
1750980819 Ivy Creek Specialty Care Emergency Medicine 201 Mariarden Rd, Dadeville, AL 36853-6244 2020-10-20
1922440833 Juan Carlos Latorre Pharmacist 201 Mariarden Rd, Dadeville, AL 36853-6244 2013-07-19
1376889063 Sabrina Colley Davis Nurse Practitioner 201 Mariarden Rd, Dadeville, AL 36853-6244 2012-12-27
1659685345 Ivy Creek of Tallapoosa LLC Medicare Defined Swing Bed Unit 201 Mariarden Rd, Dadeville, AL 36853-6244 2010-08-05
1720273303 Ivy Creek of Tallapoosa General Acute Care Hospital 201 Mariarden Rd, Dadeville, AL 36853-6244 2007-09-07
1346305216 Lake Martin Hospice LLC. Hospice Care, Community Based 201 Mariarden Rd, Dadeville, AL 36853-6244 2006-12-22
1962509182 Ivy Creek Medical Equipment, LLC Durable Medical Equipment & Medical Supplies 201 Mariarden Rd, Dadeville, AL 36853-6244 2006-09-20
1598783904 Ivy Creek of Tallapoosa, LLC General Acute Care Hospital 201 Mariarden Rd, Dadeville, AL 36853-6244 2006-07-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528378197 Ivy Creek Medical Equipment, LLC Durable Medical Equipment & Medical Supplies 201 Mariarden Road, Dadeville, AL 36853 2010-10-18
1912125535 Casey Turner Pharmacist 459 North Broadnax Street, Dadeville, AL 36853 2007-04-20
1053467100 Anthony Leon Nix Pharmacist 221 E South Street, Dadeville, AL 36853 2007-01-25
1407879083 Karen J Mockler Family Medicine 1034 South Tallassee Street, Dadeville, AL 36853 2006-07-25
1902947336 Frank Langley Pearson Pharmacist 221 E South Street, Dadeville, AL 36853 2007-02-09
1194871251 Pamela Bass Gam Pharmacist 221 E South Street, Dadeville, AL 36853 2007-01-25
1942266408 Sridhar Krishnamurti Audiologist 301 Mariarden Rd, Lake Martin Community Hospital, Dadeville, AL 36853 2006-04-25
1124298351 State of Alabama Public Health or Welfare 535 N Broadnax St, Dadeville, AL 36853-0100 2008-03-04
1164538203 Robert William Bartel General Practice 301 Mariarden Rd, Dadeville, AL 36853-0129 2006-08-22
1790717858 John Raymond Durant General Practice 301 Mariarden Rd, Ste D, Dadeville, AL 36853-0129 2006-07-07
Find all providers in zip 36853

Taxonomy Information

Taxonomy Code 146N00000X
Grouping Emergency Medical Service Providers
Classification Emergency Medical Technician, Basic

Taxonomy Definition

A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards.
Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1417589268 Jacob Michael Lezon Emergency Medical Technician, Basic 30501 Nevins St., Ft. Rucker, AL 36362 2020-02-10
1902440514 Aaron William Laube Emergency Medical Technician, Basic 28 Galt Ln, Fort Rucker, AL 36362-2304 2019-11-06
1528615408 Zeronica Freeman Mayo Emergency Medical Technician, Basic 608 Dogwood Ave, Opelika, AL 36801-7006 2019-08-24
1659812733 Rebecka Nisbet Emergency Medical Technician, Basic Andrews Avenue Building 301, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 2017-03-09
1720493620 Nathan Kennedy Emergency Medical Technician, Basic 8350 3rd Ave Unit 284, Fort Rucker, AL 36362-2039 2014-06-30
1477978609 Stacey Fleming Emergency Medical Technician, Basic 1603 5th Ave N, Birmingham, AL 35203-1922 2014-02-25
1548503469 Lindsey Taylor Mendenhall Emergency Medical Technician, Basic Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 2013-03-28
1194065805 Brian Joseph Butler Emergency Medical Technician, Basic Bulding 301 Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 2013-02-18
1568718955 Daniel Joseph Grondin Emergency Medical Technician, Basic Lyster Army Health Clinc, Bldg 301 Andrews Ave, Ft Rucker, AL 36362-5333 2012-08-03
1588922108 Zachary Thomas Fennell Emergency Medical Technician, Basic Building 301, Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 2012-05-02
Find all providers with the same taxonomy

Competitor

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City DADEVILLE
Zip Code 36853

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Dataset Information

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.

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