IVY CREEK OF TALLAPOOSA LLC NPI 1598783904

NPI Information

NPI: 1598783904
Provider Name: IVY CREEK OF TALLAPOOSA, LLC
Classification: General Acute Care Hospital - 282NR1301X
Specialization: Rural
Entity Type: Organization
Doing Business As: LAKE MARTIN COMMUNITY HOSPITAL
Address: 201 MARIARDEN RD
DADEVILLE, AL
ZIP 36853
Phone: (256) 825-7821

Map and Directions

Get Directions

NPI Details

IVY CREEK OF TALLAPOOSA, LLC is a rural general acute care hospital in Dadeville, AL. IVY CREEK OF TALLAPOOSA, LLC NPI is 1598783904. The provider is registered as an organization entity type.
The provider Is Doing Business As Lake Martin Community Hospital.

The provider's business location address is:

201 MARIARDEN RD
DADEVILLE, AL
ZIP 36853-244
Phone: (256) 825-7821
Fax: (256) 825-5899

The provider's authorized official is Michael D Bruce .
The authorized official title is Ceo and has the following contact phone number (334) 567-4311.

The enumeration date for this NPI number is 7/17/2006 and was last updated on 4/5/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NR1301X	General Acute Care Hospital	Rural	11872	ALABAMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	529916200	MEDICAID	ALABAMA
2	HOS0052H	MEDICAID	ALABAMA
3	01D0641802	OTHER	ALABAMA	CLIA
4	BCBS	OTHER	ALABAMA	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI