Individual provider Active NPI

Kirby Lamar Hart, M.D.

  • Gynecology Physician
  • Dothan, AL
National Provider Identifier
1295711760
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
AL07069 Issued in AL
Practice address
2431 W Main St
Ste 501
Dothan, AL 36301-1217
Phone
(334) 793-9222
Fax
(334) 671-0322
NPI assigned
Dec 16, 2005
Last updated
Jun 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X AL07069 AL Primary

Addresses

Primary practice location

2431 W Main St
Ste 501
Dothan, AL 36301-1217

Mailing address

2431 W Main St
Ste 501
Dothan, AL 36301-1217
Phone (334) 793-9222

Other identifiers 8

IdentifierTypeStateIssuer
12233OtherCOVENTRY HEALTH CARE
00488617AMedicaidGA
102I168271OtherPTAN
511-17846OtherALBCBSAL LOCATION ID NUMBER
7410413OtherUNITED HEALTHCARE
7207217OtherCIGNA
046793600MedicaidFL
00010721MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AL07069ALMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whitefish Dermatology LLC Current Accepting new patients
K. Lamar Hart Jr MD Gynecology PastSince Jan 1, 1990 Accepting new patients
Wiregrass Clinic LLC PastSince Oct 16, 2017 Accepting new patients
Cutaneous Oncology & Surgery Center, LLC Past Accepting new patients

Locations

2431 W Main St
Ste 501
Dothan, AL 36301
Phone (334) 793-9222

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1295711760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 W MAIN ST",
            "address_2": "STE 501",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011217",
            "telephone_number": "334-793-9222",
            "fax_number": "334-671-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 W MAIN ST",
            "address_2": "STE 501",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011217",
            "telephone_number": "334-793-9222",
            "fax_number": "334-671-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "KIRBY",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AL",
            "license": "AL07069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH CARE",
            "identifier": "12233",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00488617A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "102I168271",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAL LOCATION ID NUMBER",
            "identifier": "511-17846",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "7410413",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7207217",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046793600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00010721",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; 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.