Organization Active NPI

Super Kids Urgent Care, PLLC

  • Pediatrics Physician
  • Owens Cross Roads, AL
National Provider Identifier
1295699635
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SUPER KIDS URGENT CARE, PLLC
Practice address
322 Sutton Rd SE Ste a
Owens Cross Roads, AL 35763-9422
Phone
(601) 540-8782
NPI assigned
Dec 10, 2025
Last updated
Dec 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Mr. Macon C. Overton III, PNP-AC/PCNPI 1962974147
Title
Owner, Nurse Practitioner
Phone
(601) 540-8782

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

322 Sutton Rd SE Ste a
Owens Cross Roads, AL 35763-9422

Mailing address

322 Sutton Rd SE Ste a
Owens Cross Roads, AL 35763-9422
Phone (601) 540-8782

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2337848Super Kids Urgent Care PLLC322 Sutton Road, Ste a, Owens Cross Roads, AL 35763Certificate of waiverJan 29, 2028

National Provider Directory

National Provider Directory

Locations

322 Sutton Rd SE
Ste A
Owens Cross Roads, AL 35763
Phone (601) 540-8782

Practitioners & affiliated clinicians

Practitioners 1

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": "1765324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1295699635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 SUTTON RD SE STE A",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357639422",
            "telephone_number": "601-540-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SUTTON RD SE STE A",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357639422",
            "telephone_number": "601-540-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER KIDS URGENT CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-10",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "OVERTON",
        "authorized_official_first_name": "MACON",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER, NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-540-8782",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PNP-AC/PC"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owens Cross Roads, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.