OrganizationActive
Medcenter Fayette, LLC
NPI 1235590001 · Family Medicine Physician · Fayette, AL
Provider details
- NPI number
- 1235590001
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Tuscaloosa Medcenter North, PC
- Organization subpart
- Yes
- Authorized official
- Beth Kohn, Credentialing Specialist(912) 756-2273
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 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
122 17th Ct Ne
Fayette, AL 35555-1353
Phone: (205) 330-1707
Fax: (205) 333-0782
Street-level locationGet directions
Mailing address
3909 Mcfarland Blvd
Northport, AL 35476-2838
Registry dates
- Enumerated
- 2016-03-08
- Last updated
- 2024-12-19
- Certified
- 2024-12-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.