Kenneth L. Elmer, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

11891 Issued in AL

Practice address

832 Princeton Ave SW
Birmingham, AL 35211-1320

Phone

(205) 206-8480

Fax

(205) 206-8365

NPI assigned

Aug 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

• bcbs alabama network 01C0
• bcbs alabama network 01H0
• bcbs alabama network 01A0
• bcbs alabama network 01E0
• bcbs alabama network 01I0
• bcbs alabama network 01B0
• bcbs alabama network 01G0

Interoperability endpoints

• Direct secure messaging: kelmer4214@baptisthealthaldirect.org

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.

• Simon Williamson Clinic Pediatrics PC

  • Pediatrics Physician
  • Birmingham, AL
  • NPI 1154031789
  NPD (past)

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1174631311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12366",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352022366",
            "telephone_number": "205-780-7101",
            "fax_number": "205-206-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 PRINCETON AVE SW",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111320",
            "telephone_number": "205-206-8480",
            "fax_number": "205-206-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMER",
        "first_name": "KENNETH",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "11891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000015868",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "15868",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• India Ellison
• Jenny Ellison, M.S., CCC-SLP
• Pamela Nichelle Ellison, MLT
• Sarah Genell Ellison, CRNA
• Elm Counseling
• Jessica T Elmes, CRNA
• Craig A Elmets, MD
• Laurie Melamed Elmets, M.A.,CCC/A
• Danielle Elmore, DO
• Lindsey Elmore, PHARMD

• Pediatrics Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.