| Fmg Primecare LLC | |
|
4126 W Main St Dothan AL 36305-9310 | |
| (334) 793-2120 | |
| Not Available |
| Full Name | Fmg Primecare LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 4126 W Main St, Dothan, Alabama |
| Authorized Official Name and Position | Kristina Music (DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8778929815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fmg Primecare LLC Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7230 | Fmg Primecare LLC 4126 W Main St Dothan AL 36305-9310 Ph: (334) 793-2120 |
| NPI Number | 1427578228 |
|---|---|
| Provider Enumeration Date | 06/22/2017 |
| Last Update Date | 07/24/2025 |
| Certification Date | 07/24/2025 |
| Medicare PECOS PAC ID | 7012283864 |
|---|---|
| Medicare Enrollment ID | O20171023000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427578228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 207R00000X | Internal Medicine | () | Secondary |
| Provider Name | Mathew G Krista |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093779738 PECOS PAC ID: 2961403001 Enrollment ID: I20070116000565 |
| Provider Name | Kenneth F Cox |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730158809 PECOS PAC ID: 1355423286 Enrollment ID: I20080429000479 |
| Provider Name | Yusef Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699904243 PECOS PAC ID: 5597911487 Enrollment ID: I20120808000770 |
| Provider Name | Krystal Sims Kornegay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720426133 PECOS PAC ID: 3072754787 Enrollment ID: I20130723000450 |
| Provider Name | Valerie Thomley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831570670 PECOS PAC ID: 6406164490 Enrollment ID: I20150924000664 |
| Provider Name | Meghan Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174049779 PECOS PAC ID: 3476828567 Enrollment ID: I20170928002681 |
| Provider Name | Amanda C Guettler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366831935 PECOS PAC ID: 4688068406 Enrollment ID: I20220629001526 |
| Provider Name | Cherie Shuler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760062301 PECOS PAC ID: 2062816770 Enrollment ID: I20240722001581 |
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