NPIMap

Organization Active NPI

Northeast Alabama Pediatrics, P.C.

  • Pediatrics Physician
  • Gadsden, AL
National Provider Identifier
1306946546
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NORTHEAST ALABAMA PEDIATRICS, P.C.
Practice address
829 Riverbend Dr
Gadsden, AL 35901-2556
Phone
(256) 546-4611
Fax
(256) 546-2214
NPI assigned
Sep 25, 2006
Last updated
Oct 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Authorized official

Name
Dr. Kenneth E Skelton, MDNPI 1518924547
Title
President
Phone
(256) 546-4611

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 Physician 208000000X NU Primary

Addresses

Primary practice location

829 Riverbend Dr
Gadsden, AL 35901-2556

Mailing address

829 Riverbend Dr
Gadsden, AL 35901-2556
Phone (256) 546-4611

Other identifiers 1

IdentifierTypeStateIssuer
529200440MedicaidAL

National Provider Directory

National Provider Directory

Locations

829 Riverbend Dr
Gadsden, AL 35901
Phone (256) 328-4482

Practitioners & affiliated clinicians

Practitioners 10

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1306946546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 RIVERBEND DR",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359012556",
            "telephone_number": "256-546-4611",
            "fax_number": "256-546-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 RIVERBEND DR",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359012556",
            "telephone_number": "256-546-4611",
            "fax_number": "256-546-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ALABAMA PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "SKELTON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-546-4611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529200440",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.