Kimberly M Fagan, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

14105 Issued in AL

Practice address

3125 Independence Dr
Suite 300a
Birmingham, AL 35209-4159

Phone

(205) 879-8206

Fax

(205) 271-3075

NPI assigned

Sep 27, 2006

Last updated

Feb 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• Fagan LLC

  dba Fagan Sports Medicine

  • Specialist
  • Birmingham, AL
  • NPI 1770740482
  Authorized official Same address or phone
• Andrews Sports Medicine and Orthopaedic Center

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Birmingham, AL
  • NPI 1679617526
  NPD (past)
• Alabama Sports Medicine and Ortho Center

  • Orthopaedic Surgery Physician
  • Bham, AZ
  • NPI 1487629101
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1033200167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 INDEPENDENCE DR",
            "address_2": "SUITE 300A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352094159",
            "telephone_number": "205-879-8206",
            "fax_number": "205-271-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 INDEPENDENCE DR",
            "address_2": "SUITE 300A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352094159",
            "telephone_number": "205-879-8206",
            "fax_number": "205-271-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "14105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID NUMBER",
            "identifier": "I621",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• F H Investments Inc (Inverness Apothecary)
• Madikay Essa Faal
• Isabella Fabian, MD
• Fagan LLC (Fagan Sports Medicine)
• Charles G. Fagan, M.D.
• Shannon Travis Fagan, CRNP
• Iwona Jezak Fagbongbe
• Jennifer Jacquelyn Fagen, PT, MSPT, PRPC
• Lauren Ashley Fagerstrom
• Farahnaz Fahimipour

• Specialist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.