Kids Clinic Pediatric and Adolescent Medicine

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

KIDS CLINIC PEDIATRIC AND ADOLESCENT MEDICINE

Practice address

119 Stephen J White Memorial Blvd
Talladega, AL 35160-2106

Phone

(256) 268-7775

NPI assigned

May 4, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Muhammed Khurram Siddiqui, MDNPI 1750481305

Title

Owner

Phone

(256) 268-7775

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154810224. Details of each certification follow.

• CCN 018936 Rural health clinic · Active · Details

Rural health clinic certification: CCN 018936

Legal name

KIDS CLINIC PEDIATRIC AND ADOLESCENT MEDICINE

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Mar 14, 2019

Last certification

Feb 5, 2026

Ownership / control type

1A

Organization structure

LLCProprietary

Enrollment address

119 Stephen J White Memorial Blvd
Talladega, AL 35160-2106

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

CLIA laboratory certificates

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Muhammed K. Siddiqui, M.D.

  • Pediatrics Physician
  • Talladega, AL
  • NPI 1750481305
  NPD Authorized official
• Heather Leeann Langdon

  • Primary Care Nurse Practitioner
  • Talladega, AL
  • NPI 1801468772

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1154810224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 STEPHEN J WHITE MEMORIAL BLVD",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351602106",
            "telephone_number": "256-268-7775",
            "fax_number": "256-268-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 STEPHEN J WHITE MEMORIAL BLVD",
            "city": "TALLADEGA",
            "state": "AL",
            "postal_code": "351602106",
            "telephone_number": "256-268-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS CLINIC PEDIATRIC AND ADOLESCENT MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-04",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "MUHAMMED",
        "authorized_official_middle_name": "KHURRAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-268-7775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000032739",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "G50661",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Sims Justice, DPT
• Kdreid Services LLC
• Keith a. Williamson, MD, LLC
• Khalid L Khan, M.D., P.C.
• Khalid Latif Khan, MD
• Kids Health Inc.
• Michelle Alicia King, RN
• Michael Joseph Kulovitz, D.M.D.
• Landmark Nephrology & Hypertension Clinic. P.C
• Kelsey Turner Langdale, FNP-BC

• Pediatric Adolescent Medicine Physician in Talladega, AL
• Providers in Talladega, AL by specialty
• Pediatric Adolescent Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.