Extended Family Medical Clinic
NPI 1720121395ActiveOrganization· Family Medicine· Mobile, AL
Family Medicine in Mobile, Alabama, registered in NPPES in February 2007. The authorized official on file is Angelia Deniese Blackmon, CRNP, Medical Director.
Overview
| NPI | 1720121395 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 14, 2007 |
| Last updated in NPPES | Mar 19, 2025 |
| Certified by provider | Mar 19, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Clinic/Center | 261Q00000X | 1-073404 | AL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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