Active NPI
Jennifer Lynn Kuba, DPM
- Foot Surgery Podiatrist
- Mobile, AL
National Provider Identifier
1447206347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 36.003417
- Practice address
- 1504 Springhill Ave
Mobile Outpatient Clinic
Mobile, AL 36604 - Phone
- (251) 219-3900
- NPI assigned
- May 25, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 36.003417 | OH | Primary |
Addresses
Primary practice location
1504 Springhill Ave
Mobile Outpatient Clinic
Mobile, AL 36604
Mailing address
12619 Waxwing Ave
Spanish Fort, AL 36527-5258
Phone (216) 410-5486
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36.003417 | OH | MD | Foot Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529971200000",
"number": "1447206347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12619 WAXWING AVE",
"city": "SPANISH FORT",
"state": "AL",
"postal_code": "365275258",
"telephone_number": "216-410-5486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1504 SPRINGHILL AVE",
"address_2": "MOBILE OUTPATIENT CLINIC",
"city": "MOBILE",
"state": "AL",
"postal_code": "36604",
"telephone_number": "251-219-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBA",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2018-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "OH",
"license": "36.003417",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.