Individual provider Active NPI

A. George Kudirka, M.D.

  • Specialist
  • Tuscaloosa, AL
National Provider Identifier
1316962061
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
11373 Issued in AL
Practice address
535 Jack Warner Pkwy NE
Suite B-1
Tuscaloosa, AL 35404-5751
Phone
(205) 556-2121
Fax
(205) 554-0152
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 11373 AL Primary

Addresses

Primary practice location

535 Jack Warner Pkwy NE
Suite B-1
Tuscaloosa, AL 35404-5751

Mailing address

535 Jack Warner Pkwy NE
Suite B-1
Tuscaloosa, AL 35404-5751
Phone (205) 556-2121

Other identifiers 1

IdentifierTypeStateIssuer
529202430MedicaidAL

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22293/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1316962061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 JACK WARNER PKWY NE",
            "address_2": "SUITE B-1",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045751",
            "telephone_number": "205-556-2121",
            "fax_number": "205-554-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 JACK WARNER PKWY NE",
            "address_2": "SUITE B-1",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045751",
            "telephone_number": "205-556-2121",
            "fax_number": "205-554-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDIRKA",
        "first_name": "A.",
        "middle_name": "GEORGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "11373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529202430",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; 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.