Organization Active NPI

Physical Medicine and Rehabilitation of Alabama PC

  • Pediatric Rehabilitation Medicine Physician
  • Pelham, AL
National Provider Identifier
1447845136
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
Legal business name
PHYSICAL MEDICINE AND REHABILITATION OF ALABAMA PC
Practice address
900 Oak Mountain Commons LN
Pelham, AL 35124-1484
Phone
(205) 216-7600
NPI assigned
Mar 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
Keneshia M Kirksey, MDNPI 1023147873
Title
Physician
Phone
(704) 877-9974

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P0010X Primary

Addresses

Primary practice location

900 Oak Mountain Commons LN
Pelham, AL 35124-1484

Mailing address

900 Oak Mountain Commons LN
Pelham, AL 35124-1484
Phone (205) 216-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210412000149 AL Part B Supplier - Clinic/Group Practice 2264840339 Receives reassigned benefits from 1 practitioner
Practice locations: Pelham, AL

National Provider Directory

National Provider Directory

Locations

900 Oak Mountain Commons Ln
#L
Pelham, AL 35124
Phone (205) 216-7600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1447845136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 OAK MOUNTAIN COMMONS LN",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351241484",
            "telephone_number": "205-216-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 OAK MOUNTAIN COMMONS LN",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351241484",
            "telephone_number": "205-216-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE AND REHABILITATION OF ALABAMA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "KIRKSEY",
        "authorized_official_first_name": "KENESHIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "704-877-9974",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.