Individual provider Active NPI

Kyle McDonough, DO

  • Emergency Medicine Physician
  • Huntsville, AL
National Provider Identifier
1386221166
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO.3726 Issued in AL
Practice address
101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone
(770) 793-6190
NPI assigned
Mar 26, 2021
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X DO.3726 AL Primary

Addresses

Primary practice location

101 Sivley Rd SW
Huntsville, AL 35801-4421

Mailing address

101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone (770) 793-6190

Other practice location 1

677 Church Street
Attn: GME
Marietta, GA 30060
Phone (770) 793-6190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213002364 AL Practitioner - Emergency Medicine 9234530387 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Group Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1386221166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014421",
            "telephone_number": "770-793-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014421",
            "telephone_number": "770-793-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "677 Church Street",
            "address_2": "Attn: GME",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "30060",
            "country_code": "US",
            "telephone_number": "770-793-6190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "DO.3726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.