DIABETES AND WELLNESS CLINIC OF THE SHOALS – Clinic/Center, NPI 1255892865

DIABETES AND WELLNESS CLINIC OF THE SHOALS is a healthcare provider. based in Muscle shoals, Alabama. specializing in Clinic/Center. The NPI Number for DIABETES AND WELLNESS CLINIC OF THE SHOALS is 1255892865

Main info

Organization
Name
DIABETES AND WELLNESS CLINIC OF THE SHOALS
NPI
1255892865
Phone
(256) 856-4059
Address
1110 E 6TH ST SUITE E
Authorized Official
THADDEUS JASON BOUGHTON OWNER CRNP
Enumeration Date
27 March 2019
Last Update Date
27 March 2019
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:7State licenses:0Digital endpointsOther names

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Provider Addresses for DIABETES AND WELLNESS CLINIC OF THE SHOALS

  • 6th Street, Muscle Shoals, Colbert County, Alabama, 35661, United States

    MUSCLE SHOALS, AL 35661

    Phone: (256) 856-4059

    Type: Location

  • 114, Chappell Road, Highland Park, Muscle Shoals, Colbert County, Alabama, 35661, United States

    MUSCLE SHOALS, AL 356613650

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-07-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-07-31 (681 days ago).

Enrollment records

1

Earliest due date

2024-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20190726002747OClinic/Group PracticeAL2024-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35661)

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Reviews

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Frequently asked questions

What identifier follows DIABETES AND WELLNESS CLINIC OF THE SHOALS across health systems?
The NPI 1255892865 uniquely identifies DIABETES AND WELLNESS CLINIC OF THE SHOALS in U.S. healthcare data.
Is DIABETES AND WELLNESS CLINIC OF THE SHOALS currently accepting referrals based on NPI status?
Registry metadata lists DIABETES AND WELLNESS CLINIC OF THE SHOALS as active.
What type of care does DIABETES AND WELLNESS CLINIC OF THE SHOALS provide?
DIABETES AND WELLNESS CLINIC OF THE SHOALS's profile centers on Clinic/Center. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DIABETES AND WELLNESS CLINIC OF THE SHOALS?
DIABETES AND WELLNESS CLINIC OF THE SHOALS is associated with Muscle Shoals, Alabama in the same public data insurers reference.
Why is information missing for DIABETES AND WELLNESS CLINIC OF THE SHOALS?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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