NPIMap

Organization Active NPI

Southern Kidney Care PC

  • Nephrology Physician
  • Birmingham, AL
National Provider Identifier
1265020937
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SOUTHERN KIDNEY CARE PC
Practice address
3570 Grandview Pkwy Ste 101
Birmingham, AL 35243-2065
Phone
(205) 354-2100
Fax
(866) 343-6766
NPI assigned
Jan 7, 2021
Last updated
Jan 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Authorized official

Name
Dr. Khusbu Harshad Patel, DONPI 1699018861
Title
Owner/DO
Phone
(205) 354-2100

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

3570 Grandview Pkwy Ste 101
Birmingham, AL 35243-2065

Mailing address

3570 Grandview Pkwy Ste 101
Birmingham, AL 35243-2065
Phone (205) 354-2100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210122002294 AL Part B Supplier - Clinic/Group Practice 1850705427 Receives reassigned benefits from 7 practitioners
Practice locations: Birmingham, AL; Fultondale, AL; Jasper, AL; Sylacauga, AL

National Provider Directory

National Provider Directory

Locations

3570 Grandview Pkwy
Ste 101
Birmingham, AL 35243
Phone (205) 354-2100

Practitioners & affiliated clinicians

Practitioners 7

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": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1265020937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 GRANDVIEW PKWY STE 101",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432065",
            "telephone_number": "205-354-2100",
            "fax_number": "866-343-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 GRANDVIEW PKWY STE 101",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432065",
            "telephone_number": "205-354-2100",
            "fax_number": "866-343-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN KIDNEY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KHUSBU",
        "authorized_official_middle_name": "HARSHAD",
        "authorized_official_title_or_position": "OWNER/DO",
        "authorized_official_telephone_number": "205-354-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "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 Jan 7, 2021; 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.