Active NPI
Kira Fonbah, MD
- Child & Adolescent Psychiatry Physician
- Hoover, AL
National Provider Identifier
1306056965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 28627
- Practice address
- 2170 Clearbrook Rd Ste 103
Hoover, AL 35226-1573 - Phone
- (205) 746-8542
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 28627 | AL | Primary |
Addresses
Primary practice location
2170 Clearbrook Rd Ste 103
Hoover, AL 35226-1573
Mailing address
815 Byron Way
Hoover, AL 35226-2429
Phone (205) 746-8542
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28627 | AL | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570579200000",
"number": "1306056965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 BYRON WAY",
"city": "HOOVER",
"state": "AL",
"postal_code": "352262429",
"telephone_number": "205-746-8542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2170 CLEARBROOK RD STE 103",
"city": "HOOVER",
"state": "AL",
"postal_code": "352261573",
"telephone_number": "205-746-8542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONBAH",
"first_name": "KIRA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2019-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "AL",
"license": "28627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hoover, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.