| Dba Coosa Valley Medical Center | |
|
315 W Hickory St Sylacauga AL 35150-2913 | |
| (256) 401-4000 | |
| (256) 401-4603 |
| Full Name | Dba Coosa Valley Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 315 W Hickory St, Sylacauga, Alabama |
| Authorized Official Name and Position | Janice G Brown (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2564014606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba Coosa Valley Medical Center 315 W Hickory Street Sylacauga AL 35150-2913 Ph: (256) 401-4070 | Dba Coosa Valley Medical Center 315 W Hickory St Sylacauga AL 35150-2913 Ph: (256) 401-4000 |
| NPI Number | 1124235320 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 02/09/2012 |
| Medicare PECOS PAC ID | 5294710398 |
|---|---|
| Medicare Enrollment ID | O20040727001079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124235320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 207Q00000X (Alabama) | Primary |
| 208600000X | Surgery | 208600000X (Alabama) | Secondary |
| Provider Name | Gregory S Borucki |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013995554 PECOS PAC ID: 9739085358 Enrollment ID: I20031212000129 |
| Provider Name | Michael Alton Oliver |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568483915 PECOS PAC ID: 0840283891 Enrollment ID: I20040406000251 |
| Provider Name | Gerald L Crawford |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497703599 PECOS PAC ID: 8820075591 Enrollment ID: I20040630000956 |
| Provider Name | Max R Shiver |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184623241 PECOS PAC ID: 7315845146 Enrollment ID: I20040708000767 |
| Provider Name | Shelly R Weisenfeld |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063444644 PECOS PAC ID: 5294705489 Enrollment ID: I20040727000374 |
| Provider Name | Juan Campos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417042136 PECOS PAC ID: 8820060627 Enrollment ID: I20040811001141 |
| Provider Name | Timothy A Crump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750459343 PECOS PAC ID: 1658330436 Enrollment ID: I20041007000281 |
| Provider Name | Brian T Guffin |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1497704803 PECOS PAC ID: 5799749842 Enrollment ID: I20041117001113 |
| Provider Name | Allen L Yeilding |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1164443792 PECOS PAC ID: 5092614784 Enrollment ID: I20050216000374 |
| Provider Name | Zachary Ian Edwards |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134178569 PECOS PAC ID: 0143273615 Enrollment ID: I20050224000240 |
| Provider Name | Khaleel K Ashraf |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1760437925 PECOS PAC ID: 7416991849 Enrollment ID: I20050615001065 |
| Provider Name | Renee S Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861596090 PECOS PAC ID: 5597786079 Enrollment ID: I20051212000858 |
| Provider Name | Kay B Hare |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679539282 PECOS PAC ID: 1254347768 Enrollment ID: I20060221000563 |
| Provider Name | Shannon Alverson Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083771497 PECOS PAC ID: 5294741401 Enrollment ID: I20060224000660 |
| Provider Name | Anthony Lynn Tropeano |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033114327 PECOS PAC ID: 6103894589 Enrollment ID: I20061003000249 |
| Provider Name | Jeremiah D Peck |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437210986 PECOS PAC ID: 3577665348 Enrollment ID: I20070226000164 |
| Provider Name | Brandy S Rivers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427176031 PECOS PAC ID: 4385742071 Enrollment ID: I20070604000453 |
| Provider Name | Jennie S Wheeler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336351790 PECOS PAC ID: 3476645466 Enrollment ID: I20070822000855 |
| Provider Name | Carolyn J Prokopyk |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093834855 PECOS PAC ID: 8224120068 Enrollment ID: I20070823000839 |
| Provider Name | Jonathan M Bridges |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1598979973 PECOS PAC ID: 3678645553 Enrollment ID: I20080709000590 |
| Provider Name | Mamoun R Pacha |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871586453 PECOS PAC ID: 0446213276 Enrollment ID: I20100204000490 |
| Provider Name | Stephen R Bowen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689688111 PECOS PAC ID: 6305846916 Enrollment ID: I20100330001162 |
| Provider Name | Mohamed Ammar Aldaher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073527826 PECOS PAC ID: 3375592009 Enrollment ID: I20100512000439 |
| Provider Name | Laura G Deichmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780698225 PECOS PAC ID: 0749239473 Enrollment ID: I20100512000892 |
| Provider Name | Mohammed Mohiuddin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174588396 PECOS PAC ID: 6406988849 Enrollment ID: I20100720000664 |
| Provider Name | Clayton H Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205923554 PECOS PAC ID: 6608900030 Enrollment ID: I20100819001172 |
| Provider Name | Hubert Rodriguez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1598745598 PECOS PAC ID: 4284722216 Enrollment ID: I20120118000802 |
| Provider Name | Ronald E Maiden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063477339 PECOS PAC ID: 7315108230 Enrollment ID: I20120419000425 |
| Provider Name | David J Mooney |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1831350198 PECOS PAC ID: 8123282548 Enrollment ID: I20120615000314 |
| Provider Name | Kevin P Bevis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306000161 PECOS PAC ID: 1850547381 Enrollment ID: I20120815000641 |
| Provider Name | Matthew D Kimball |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548437718 PECOS PAC ID: 8426205543 Enrollment ID: I20120824000490 |
| Provider Name | Anthony J Nix |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770874695 PECOS PAC ID: 6002055530 Enrollment ID: I20130613000469 |
| Provider Name | John L Scott |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669723748 PECOS PAC ID: 1355593773 Enrollment ID: I20131121001356 |
| Provider Name | Carisa L Hines |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326064395 PECOS PAC ID: 1456333061 Enrollment ID: I20140218000202 |
| Provider Name | Kristina T Osborn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104182674 PECOS PAC ID: 9537309687 Enrollment ID: I20150122000865 |
| Provider Name | April S Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598154635 PECOS PAC ID: 5890013452 Enrollment ID: I20150409002570 |
| Provider Name | Tinsley Forbus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841672185 PECOS PAC ID: 7618282781 Enrollment ID: I20150818006085 |
| Provider Name | Matthew R Dimon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477871374 PECOS PAC ID: 3375852064 Enrollment ID: I20151020001784 |
| Provider Name | John W Amburgy |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1134485477 PECOS PAC ID: 3678723400 Enrollment ID: I20161027001429 |
| Provider Name | Jorge Blanco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679981120 PECOS PAC ID: 3779863311 Enrollment ID: I20161220000546 |
| Provider Name | Metta J Gulley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780126243 PECOS PAC ID: 6305121757 Enrollment ID: I20170327001072 |
| Provider Name | Tasia Bradford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366999195 PECOS PAC ID: 6507114857 Enrollment ID: I20180802003803 |
| Provider Name | Quincy A Leach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104301233 PECOS PAC ID: 4486988045 Enrollment ID: I20190702000539 |
| Provider Name | Jonathan Lance Overcash |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447693890 PECOS PAC ID: 0547401879 Enrollment ID: I20200414003016 |
| Provider Name | Hilary F Ragsdale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700382330 PECOS PAC ID: 8325393200 Enrollment ID: I20200428002027 |
| Provider Name | Nancy C Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275157596 PECOS PAC ID: 6103246624 Enrollment ID: I20201021001712 |
| Provider Name | Cater M Elliott |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760915797 PECOS PAC ID: 0042597767 Enrollment ID: I20210726000772 |
| Provider Name | Stacey Gamewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316670920 PECOS PAC ID: 3072999556 Enrollment ID: I20221006002273 |
Sylacauga Internal Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 310 W Fort Williams St, Sylacauga, AL 35150 Phone: 256-249-0061 Fax: 256-249-2033 | |
Fast Pace Medical Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 41357 Us Highway 280, Suite B, Sylacauga, AL 35150 Phone: 312-531-1109 Fax: 317-229-9199 | |
Lhm Clinic, P.c. Of Sylacauga Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 N Main Ave, Sylacauga, AL 35150 Phone: 256-245-9140 Fax: 256-245-9142 | |
Sylacauga Obstetrics And Primary Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 W Spring St, Suite 100, Sylacauga, AL 35150 Phone: 256-249-5888 Fax: 256-249-5040 | |
Glory Springs Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1023 W Fort Williams St, Sylacauga, AL 35150 Phone: 256-369-1735 | |
Craddock Health Center P C Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 209 W Spring St, Suite 200, Sylacauga, AL 35150 Phone: 256-245-5241 Fax: 256-245-0194 |