Individual provider Active NPI

Kendall F Roper, PA

  • Surgical Physician Assistant
  • Montgomery, AL
National Provider Identifier
1477633279
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA481 Issued in AL
Practice address
2055 E South Blvd
Suite 601
Montgomery, AL 36116-2001
Phone
(334) 281-9000
NPI assigned
Oct 16, 2006
Last updated
Sep 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA481 AL Primary

Addresses

Primary practice location

2055 E South Blvd
Suite 601
Montgomery, AL 36116-2001

Mailing address

2055 E South Blvd
Suite 601
Montgomery, AL 36116-2001
Phone (334) 281-9000

Other identifiers 1

IdentifierTypeStateIssuer
PA481OtherALSTATE PA LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061214000537 AL Practitioner - Physician Assistant 8527067842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
STV Orthopedic Surgeons LLCGroup PAC ID 8224313614, 15 clinicians

Practice addresses (Care Compare)

2030 Lay Dam Rd
Clanton, AL 35045-8344
Phone (205) 663-5775

810 Saint Vincents Dr
Birmingham, AL 35205-1601
Phone (205) 939-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA481ALMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services Inc Current Accepting new patients
Alabama Coastal Radiology, PC Past Accepting new patients

Locations

107 Medical Center Dr
Clanton, AL 35045
Phone (205) 280-1478

Interoperability endpoints

  • Direct secure messaging: kendall.roper.1@321.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1477633279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD",
            "address_2": "SUITE 601",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162001",
            "telephone_number": "334-281-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD",
            "address_2": "SUITE 601",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162001",
            "telephone_number": "334-281-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROPER",
        "first_name": "KENDALL",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PA LICENSE",
            "identifier": "PA481",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.