Active NPI
Bradley Lamar Kirby, RN
- Registered Nurse
- Elkmont, AL
National Provider Identifier
1295962942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 1-090571
- Practice address
- 29495 Copperhead Lane
Elkmont, AL 35620 - Phone
- (256) 732-4452
- Fax
- (256) 732-4430
- NPI assigned
- Jun 19, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1-090571 | AL | Primary |
| Pediatric Registered Nurse | 163WP0200X | 1-090571 | AL |
Addresses
Primary practice location
29495 Copperhead Lane
Elkmont, AL 35620
Mailing address
500 Governors Drive SW
Huntsville, AL 35801
Phone (256) 518-9998
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-090571 | AL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245369600000",
"number": "1295962942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 GOVERNORS DRIVE SW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "35801",
"telephone_number": "256-518-9998",
"fax_number": "256-518-9941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29495 COPPERHEAD LANE",
"city": "ELKMONT",
"state": "AL",
"postal_code": "35620",
"telephone_number": "256-732-4452",
"fax_number": "256-732-4430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRBY",
"first_name": "BRADLEY",
"middle_name": "LAMAR",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-19",
"last_updated": "2009-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AL",
"license": "1-090571",
"primary": true
},
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "AL",
"license": "1-090571",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkmont, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.