Individual provider Active NPI

Sidney Lankford Jr.

  • Acute Care Nurse Practitioner
  • Pelham, AL
National Provider Identifier
1164974630
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-107882 Issued in AL
Practice address
153 Wild Timber Pkwy
Pelham, AL 35124-2530
Phone
(205) 586-2011
NPI assigned
Oct 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-107882 AL Primary

Addresses

Primary practice location

153 Wild Timber Pkwy
Pelham, AL 35124-2530

Mailing address

153 Wild Timber Pkwy
Pelham, AL 35124-2530
Phone (205) 586-2011

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260327000281 AL Practitioner - Nurse Practitioner 7618452772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-107882ALMDAcute Care Nurse Practitioner

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1164974630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 WILD TIMBER PKWY",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242530",
            "telephone_number": "205-586-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 WILD TIMBER PKWY",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242530",
            "telephone_number": "205-586-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANKFORD",
        "first_name": "SIDNEY",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-31",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-107882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

Verify at the official NPI Registry.