| Rural Health Medical Program, Inc. | |
|
1310 Washington Street Marion AL 36756-3218 | |
| (334) 683-2073 | |
| (334) 683-2077 |
| Full Name | Rural Health Medical Program, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1310 Washington Street, Marion, Alabama |
| Authorized Official Name and Position | Patricia Gibson (CEO) |
| Authorized Official Contact | 3348747428 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rural Health Medical Program, Inc. P O Box 2213 228 Selma Avenue Selma AL 36702-2213 Ph: (334) 874-4728 | Rural Health Medical Program, Inc. 1310 Washington Street Marion AL 36756-3218 Ph: (334) 683-2073 |
| NPI Number | 1437238151 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 12/21/2010 |
| Medicare PECOS PAC ID | 0143219196 |
|---|---|
| Medicare Enrollment ID | O20040506001178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437238151 | NPI | - | NPPES |
| 630000008 | Medicaid | AL | |
| 011914 | Other | AL | MEDICARE ID - TYPE UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Alabama) | Primary |
| Provider Name | Jamil Akhtar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245319144 PECOS PAC ID: 3173512142 Enrollment ID: I20040506001299 |
| Provider Name | Glenn S Mcphillips |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104821222 PECOS PAC ID: 8729071097 Enrollment ID: I20041227000512 |
| Provider Name | Tomeko L Mcphillips |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821093949 PECOS PAC ID: 3173516440 Enrollment ID: I20041228000017 |
| Provider Name | Keturah Craig |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1386814457 PECOS PAC ID: 7214016252 Enrollment ID: I20080502000147 |
| Provider Name | Dyjerlynn C Lampley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760453773 PECOS PAC ID: 3678649985 Enrollment ID: I20080911000159 |
| Provider Name | Sonja S Howard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083879548 PECOS PAC ID: 6204903412 Enrollment ID: I20080930000093 |
| Provider Name | Edgar W Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902985708 PECOS PAC ID: 5698823052 Enrollment ID: I20090423000492 |
| Provider Name | Thomas W Broughton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073778023 PECOS PAC ID: 0941472872 Enrollment ID: I20111018000711 |
| Provider Name | Edward Childs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497797575 PECOS PAC ID: 2860642345 Enrollment ID: I20121017000972 |
| Provider Name | Deborah R Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730268566 PECOS PAC ID: 9931359130 Enrollment ID: I20121024000660 |
| Provider Name | Sabrina Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376889063 PECOS PAC ID: 7113172826 Enrollment ID: I20130304000241 |
| Provider Name | Breena R Till |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376976183 PECOS PAC ID: 5597909804 Enrollment ID: I20130926000052 |
| Provider Name | Demetric Childs-hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396168985 PECOS PAC ID: 8628299567 Enrollment ID: I20141018000190 |
| Provider Name | Ashley N Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114395852 PECOS PAC ID: 8921307786 Enrollment ID: I20160428001350 |
| Provider Name | Letevia K Herlong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659893469 PECOS PAC ID: 6507132503 Enrollment ID: I20171018003140 |
| Provider Name | Anetrial King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992229892 PECOS PAC ID: 0345507182 Enrollment ID: I20171201002311 |
| Provider Name | Jackie Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831614452 PECOS PAC ID: 6608133467 Enrollment ID: I20171204000104 |
| Provider Name | Lakrimbrell Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548782733 PECOS PAC ID: 9032477567 Enrollment ID: I20171211001599 |
| Provider Name | Joseph Hime |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528324811 PECOS PAC ID: 8123337201 Enrollment ID: I20180712001039 |
| Provider Name | Susan N Bettis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437661030 PECOS PAC ID: 2264789619 Enrollment ID: I20180717002816 |
| Provider Name | Evelyn P Evans |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295871556 PECOS PAC ID: 0345304143 Enrollment ID: I20180828002525 |
| Provider Name | Gregory R Renck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275645400 PECOS PAC ID: 2668557455 Enrollment ID: I20180919003048 |
| Provider Name | Cortessia Badie Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487046132 PECOS PAC ID: 1951643766 Enrollment ID: I20190426001792 |
| Provider Name | Iverson B Hopson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1881865400 PECOS PAC ID: 6800138488 Enrollment ID: I20190501000485 |
| Provider Name | Anna Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093373052 PECOS PAC ID: 7214264217 Enrollment ID: I20190814001637 |
| Provider Name | Amanda Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710529953 PECOS PAC ID: 6709214059 Enrollment ID: I20200319001470 |
| Provider Name | Allison Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952951584 PECOS PAC ID: 1850721218 Enrollment ID: I20200427000764 |
| Provider Name | Menthola Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558987990 PECOS PAC ID: 7113331380 Enrollment ID: I20210129000311 |
| Provider Name | Olusunmisola Oyeronke Oyesiku |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336634187 PECOS PAC ID: 5294169728 Enrollment ID: I20220224000768 |
| Provider Name | Shaqualyn Taite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881211019 PECOS PAC ID: 6406241660 Enrollment ID: I20220325000158 |
| Provider Name | Rita Branch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104423235 PECOS PAC ID: 3577945435 Enrollment ID: I20220809002406 |
| Provider Name | Kimberly T Fountain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740419688 PECOS PAC ID: 2567750292 Enrollment ID: I20221101000987 |
| Provider Name | Rhonda L. Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386359057 PECOS PAC ID: 0547635807 Enrollment ID: I20230419000736 |
| Provider Name | Samuel W Mcalpine |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1881673804 PECOS PAC ID: 0840429957 Enrollment ID: I20230602001758 |
| Provider Name | Beverly A Gayle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841957180 PECOS PAC ID: 3375900939 Enrollment ID: I20230613002062 |
| Provider Name | Olufunke M Adebayo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821625351 PECOS PAC ID: 4082032958 Enrollment ID: I20230809001468 |
| Provider Name | Lauren P Joyner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144897026 PECOS PAC ID: 4688017379 Enrollment ID: I20240209001320 |
| Provider Name | Cecilia Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205697547 PECOS PAC ID: 5890239339 Enrollment ID: I20240626000687 |
| Provider Name | Jamia Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275361230 PECOS PAC ID: 4789110339 Enrollment ID: I20241206000662 |
Vaughan Regional Medical Center Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Highway 45 South, Route 2, Box 4-d, Marion, AL 36756 Phone: 334-683-9085 |