| NPI | 1184612095 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2005-10-13 |
| Last Updated | 2023-03-07 |
| Mailing Address | 94 Medical Cir Moulton, AL 35650-1256 United States Phone: (256) 974-9216 | Fax: (256) 974-8211 📍 View Map |
| Primary Practice Address | 94 Medical Cir Moulton, AL 35650-1256 United States Phone: (256) 974-9216 | Fax: (256) 974-8211 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | AL | 00012662 | CDS |
| Other (non-Medicare) | AL | 01D0302603 | CLIA |
| Other (non-Medicare) | AL | 12662 | Medical License |
| MEDICAID | AL | 529402270 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 172V00000X – Community Health Worker | AL | 12662 |
| No | 207N00000X – Dermatology | AL | 12662 |
| No | 207QA0505X – Family Medicine, Adult Medicine | AL | 12662 |
| Yes | 207Q00000X – Family Medicine | AL | 12662 |
| No | 207QS0010X – Family Medicine, Sports Medicine | AL | 12662 |
| No | 207RE0101X – Internal Medicine, Endocrinology, Diabetes & Metabolism | AL | 12662 |
| No | 207QG0300X – Family Medicine, Geriatric Medicine | AL | 12662 |
| No | 207RH0005X – Internal Medicine, Hypertension Specialist | AL | 12662 |
| No | 2084P0800X – Psychiatry & Neurology, Psychiatry | AL | 12662 |
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About NPI 1184612095
Samuel Nixon Gillespie MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1184612095. The primary specialty listed is Family Medicine. The provider is located in Moulton, AL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-10-13. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1184612095?
NPI 1184612095 belongs to Samuel Nixon Gillespie MD, a Family Medicine in Moulton, AL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1184612095 active?
The current status of NPI 1184612095 in the NPPES registry is Active. The record was last updated on 2023-03-07.
What specialty is NPI 1184612095?
NPI 1184612095 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1184612095?
You can verify NPI 1184612095 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1184612095?
The primary practice address on file for NPI 1184612095 is 94 Medical Cir, Moulton, AL 35650-1256. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1184612095 issued?
NPI 1184612095 was first issued (enumerated) on 2005-10-13. The NPPES record was last updated on 2023-03-07.
Practice Location Map
Samuel Nixon Gillespie is located at 94 Medical Cir, Moulton, AL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Samuel Nixon Gillespie. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1184612095. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Community Health Worker | 12662 | AL |
| Dermatology | 12662 | AL |
| Family Medicine, Adult Medicine | 12662 | AL |
| Family Medicine | 12662 | AL |
| Family Medicine, Sports Medicine | 12662 | AL |
| Internal Medicine, Endocrinology, Diabetes & Metabolism | 12662 | AL |
| Family Medicine, Geriatric Medicine | 12662 | AL |
| Internal Medicine, Hypertension Specialist | 12662 | AL |
| Psychiatry & Neurology, Psychiatry | 12662 | AL |