Individual provider Active NPI

Roger Williams Kemp, M.D.

  • Interventional Pain Medicine Physician
  • Montgomery, AL
National Provider Identifier
1104984624
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
15752 Issued in AL
Practice address
1722 Pine St
Suite 704
Montgomery, AL 36106-1103
Phone
(334) 264-3302
Fax
(334) 264-3305
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 15752 AL Primary

Addresses

Primary practice location

1722 Pine St
Suite 704
Montgomery, AL 36106-1103

Mailing address

1722 Pine St
Suite 704
Montgomery, AL 36106-1103
Phone (334) 264-3302

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130606000246 AL Practitioner - AnesthesiologyPractitioner - Pain ManagementPractitioner - Other (Physician) 5799845756

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15752ALMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Alabama Pain Management Center, P.C. Current Accepting new patients

Locations

1709 Forest Ave
Montgomery, AL 36106
Phone (205) 270-1771

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104984624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 PINE ST",
            "address_2": "SUITE 704",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061103",
            "telephone_number": "334-264-3302",
            "fax_number": "334-264-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 PINE ST",
            "address_2": "SUITE 704",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061103",
            "telephone_number": "334-264-3302",
            "fax_number": "334-264-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "ROGER",
        "middle_name": "WILLIAMS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AL",
            "license": "15752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.