Individual provider Active NPI

R Rex Payne, M.D.

  • Dermatopathology Physician
  • Birmingham, AL
National Provider Identifier
1134264872
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
00006700 Issued in AL
Practice address
48 Medical Park Dr E
Suite 458
Birmingham, AL 35235-3400
Phone
(205) 838-1811
Fax
(205) 838-5958
NPI assigned
Feb 20, 2007
Last updated
Jun 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 00006700 AL Primary

Addresses

Primary practice location

48 Medical Park Dr E
Suite 458
Birmingham, AL 35235-3400

Mailing address

48 Medical Park Dr E
Suite 458
Birmingham, AL 35235-3400
Phone (205) 838-1811

Other identifiers 2

IdentifierTypeStateIssuer
051078860OtherALBC BS OF ALABAMA
000078860MedicaidAL

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00006700ALMDDermatopathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1134264872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E",
            "address_2": "SUITE 458",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353400",
            "telephone_number": "205-838-1811",
            "fax_number": "205-838-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E",
            "address_2": "SUITE 458",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353400",
            "telephone_number": "205-838-1811",
            "fax_number": "205-838-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "R",
        "middle_name": "REX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "AL",
            "license": "00006700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF ALABAMA",
            "identifier": "051078860",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000078860",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.