Individual provider Active NPI

Kaitlin Johnson, MD

  • Pediatric Anesthesiology Physician
  • Birmingham, AL
National Provider Identifier
1063706208
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
MD.33463 Issued in AL
Practice address
1600 7TH Ave S # 420
Birmingham, AL 35233-1711
Phone
(205) 939-9235
Fax
(215) 590-2768
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT199233 PA
Pediatric Anesthesiology Physician 207LP3000X MD.33463 AL Primary

Addresses

Primary practice location

1600 7TH Ave S # 420
Birmingham, AL 35233-1711

Mailing address

1600 7TH Ave S # 420
Birmingham, AL 35233-1711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.33463ALMDPediatric Anesthesiology Physician
MT199233PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Anesthesia Associates PC CurrentSince Feb 13, 2021 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jul 1, 2014 Accepting new patients
University of Alabama Health Services Foundation, PC Pediatrics CurrentSince Jul 1, 2014 Accepting new patients

Locations

1600 7th Ave S
#420
Birmingham, AL 35233
Phone (205) 638-9235

703 Volker Hall
Birmingham, AL 35294
Phone (205) 638-9587

1600 7th Ave S
Birmingham, AL 35233
Phone (205) 638-9100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1063706208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S # 420",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S # 420",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-939-9235",
            "fax_number": "215-590-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAITLIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT199233",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "AL",
            "license": "MD.33463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.