NPIMap

Organization Active NPI

Southern Pain Specialists, P.C.

  • Interventional Pain Medicine Physician
  • Birmingham, AL
National Provider Identifier
1174697106
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
19582 Issued in AL
Legal business name
SOUTHERN PAIN SPECIALISTS, P.C.
Practice address
7191 Cahaba Valley Rd
Suite 204
Birmingham, AL 35242-6402
Phone
(205) 995-9967
Fax
(205) 995-0635
NPI assigned
Nov 20, 2006
Last updated
Jun 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Authorized official

Name
Dr. Kenneth G Varley, M.D.NPI 1043380900
Title
President
Phone
(205) 995-9967

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 491 AL
Interventional Pain Medicine Physician 208VP0014X 19582 AL Primary

Addresses

Primary practice location

7191 Cahaba Valley Rd
Suite 204
Birmingham, AL 35242-6402

Mailing address

7191 Cahaba Valley Rd
Suite 204
Birmingham, AL 35242-6402
Phone (205) 995-9967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051025000711 AL Part B Supplier - Clinic/Group Practice 9032136429 Receives reassigned benefits from 4 practitioners
Practice locations: Birmingham, AL

National Provider Directory

National Provider Directory

Locations

7500 Hugh Daniel Dr
Birmingham, AL 35242
Phone (205) 995-4900

7191 Cahaba Valley Rd
Ste 204
Hoover, AL 35242
Phone (205) 995-9163

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1174697106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7191 CAHABA VALLEY RD",
            "address_2": "SUITE 204",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352426402",
            "telephone_number": "205-995-9967",
            "fax_number": "205-995-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7191 CAHABA VALLEY RD",
            "address_2": "SUITE 204",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352426402",
            "telephone_number": "205-995-9967",
            "fax_number": "205-995-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PAIN SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "VARLEY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-995-9967",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "491",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AL",
            "license": "19582",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.