Individual provider Active NPI

Kathy L Redwood, CRNP

  • Pediatric Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1376572685
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1-025926 Issued in AL
Practice address
1400 4TH Ave S
Birmingham, AL 35233-1511
Phone
(205) 329-7200
Fax
(205) 329-7250
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1-025926 AL Primary

Addresses

Primary practice location

1400 4TH Ave S
Birmingham, AL 35233-1511

Mailing address

1400 4TH Ave S
Birmingham, AL 35233-1511
Phone (205) 329-7200

Other identifiers 2

IdentifierTypeStateIssuer
009915970MedicaidAL
51518328OtherBLUE CROSS BLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
1-025926ALMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Children'S Hospital of Alabama Past Accepting new patients
The Children'S Hospital of Alabama Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376572685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 4TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331511",
            "telephone_number": "205-329-7200",
            "fax_number": "205-329-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 4TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331511",
            "telephone_number": "205-329-7200",
            "fax_number": "205-329-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDWOOD",
        "first_name": "KATHY",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-025926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009915970",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51518328",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.