Active NPI
Kaci M Byrd Cheeseman, P.A.
- Physician Assistant
- Mount Vernon, AL
National Provider Identifier
1013245257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA681
- Practice address
- 950 W Coy Smith Hwy
Mount Vernon, AL 36560-3201 - Phone
- (251) 829-9884
- Fax
- (251) 829-9507
- NPI assigned
- Nov 30, 2009
- Last updated
- Dec 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA681 | AL | Primary |
Addresses
Primary practice location
950 W Coy Smith Hwy
Mount Vernon, AL 36560-3201
Mailing address
251 N Bayou St
Mobile, AL 36603-5827
Phone (251) 690-8158
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 630000013 | Medicaid | AL | |
| 011846 | Other | AL | MAIN GROUP MEDICARE PAYEE NUMBER |
| 1063439065 | Other | AL | GROUP NPI PAYEE NUMBER |
Other names 1
- Kaci Marie Byrd
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile County Board of Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Family Oriented Primary Health Care Clinic, Inc.
- Federally Qualified Health Center (FQHC)
- Mobile, AL
- NPI 1063439065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385942400000",
"number": "1013245257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 N BAYOU ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366035827",
"telephone_number": "251-690-8158",
"fax_number": "251-544-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 W COY SMITH HWY",
"city": "MOUNT VERNON",
"state": "AL",
"postal_code": "365603201",
"telephone_number": "251-829-9884",
"fax_number": "251-829-9507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYRD CHEESEMAN",
"first_name": "KACI",
"middle_name": "M",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-30",
"last_updated": "2013-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AL",
"license": "PA681",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630000013",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAIN GROUP MEDICARE PAYEE NUMBER",
"identifier": "011846",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI PAYEE NUMBER",
"identifier": "1063439065",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KACI",
"last_name": "BYRD",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mount Vernon, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.