Southern Divine Family Medical Center LLC
NPI 1104456920 · Internal Medicine Physician · Altoona, AL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1104456920
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Enrico Gaspar, Owner(256) 840-8181
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Acute Care Nurse Practitioner363LA2100X
Physician Assistants & Advanced Practice Nursing Providers
- Adult Health Nurse Practitioner363LA2200X
Physician Assistants & Advanced Practice Nursing Providers
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- United Doctors Family Medical Center - Altoona
Registry dates
- Enumerated
- 2020-01-21
- Last updated
- 2022-04-09
- Certified
- 2022-04-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.