Charles Keith Funderburk, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8358 Issued in AL

Practice address

108 Medical Center Dr
Clanton, AL 35045-2332

Phone

(205) 755-5700

Fax

(205) 755-4966

NPI assigned

Oct 19, 2005

Last updated

Feb 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Alabama School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chilton Medical Group P CGroup PAC ID 9638197460, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Hoover, AL, CCN 017009
• St Vincent's Chilton Hospital, Clanton, AL, CCN 010173

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• bcbs alabama network 01H0
• bcbs alabama network 01C0
• bcbs alabama network 01I0
• bcbs alabama network 01E0
• bcbs alabama network 01A0
• bcbs alabama network 01B0
• bcbs alabama network 01G0

Interoperability endpoints

• Direct secure messaging: charles.funderburk@chiltmedassoc.direct.medconnect-inc.com

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.

• Chilton Medical Group P C

  • Legal Medicine
  • Clanton, AL
  • NPI 1629121553
  Medicare reassignment Care Compare group NPD
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459
  NPD (past)
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eh Health Home Health of Birmingham, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Hoover, AL
  • NPI 1629539077
  Care Compare affiliation
• St Vincents Chilton LLC

  dba St Vincents Chilton Swing Beds

  • Medicare Defined Swing Bed Hospital Unit
  • Clanton, AL
  • NPI 1013365824
  Care Compare affiliation
• St Vincents Chilton LLC

  dba Ascension St. Vincent's Chilton

  • General Acute Care Hospital
  • Clanton, AL
  • NPI 1093171860
  Care Compare affiliation

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1447249750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1850",
            "city": "CLANTON",
            "state": "AL",
            "postal_code": "350461850",
            "telephone_number": "205-755-5700",
            "fax_number": "205-755-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MEDICAL CENTER DR",
            "city": "CLANTON",
            "state": "AL",
            "postal_code": "350452332",
            "telephone_number": "205-755-5700",
            "fax_number": "205-755-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDERBURK",
        "first_name": "CHARLES",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "8358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fast Pace Medical Clinic PLLC (Fast Pace Health)
• Ashley Ferguson, LPC
• Emma Fletcher, SLP
• Phillip Dewey Foshee, M.D.
• Kimberly Fridy
• Katie Rebecca Fussell, PHARM D
• Gadsden Hearing Aid, Inc. (Wright Hearing Center)
• Tracey Johnson Garrett, LMSW
• Sharon Glass, DMD
• Wanda Gothard

• Family Medicine Physician in Clanton, AL
• Providers in Clanton, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.