NPIMap

Organization Active NPI

Set Apart Pediatrics LLC

Doing business as Set Apart Pediatrics

  • Pediatrics Physician
  • Decatur, AL
National Provider Identifier
1124847983
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SET APART PEDIATRICS LLC
Doing business as
Set Apart Pediatrics
Practice address
2112 6TH Ave SE
Decatur, AL 35601-6510
Phone
(256) 274-5640
Fax
(256) 274-5642
NPI assigned
Oct 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Authorized official

Name
Kimberly A Dudley, MDNPI 1154749554
Title
Owner Physician
Phone
(256) 508-1682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2112 6TH Ave SE
Decatur, AL 35601-6510

Mailing address

1862 Sharp Ford Rd
Valhermoso Springs, AL 35775-7502
Phone (256) 508-1682

Other names 1

  • Set Apart Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2313811Set Apart Pediatrics2112 6TH Avenue SE, Decatur, AL 35601AccreditationSep 23, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1124847983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1862 SHARP FORD RD",
            "city": "VALHERMOSO SPRINGS",
            "state": "AL",
            "postal_code": "357757502",
            "telephone_number": "256-508-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 6TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016510",
            "telephone_number": "256-274-5640",
            "fax_number": "256-274-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SET APART PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "256-508-1682",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Set Apart Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.