Kimbrell L Colburn, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA7 Issued in AL

Practice address

805 Saint Vincents Dr
Suite 100
Birmingham, AL 35205-1636

Phone

(205) 939-3699

Fax

(205) 939-0989

NPI assigned

Mar 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Premise Health of Alabama Medical PC

  • Multi-Specialty Clinic/Center
  • Vance, AL
  • NPI 1518631514
  NPD
• Alabama Sports Medicine and Ortho Center

  • Orthopaedic Surgery Physician
  • Bham, AZ
  • NPI 1487629101
  NPD (past)

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1497722391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SAINT VINCENTS DR",
            "address_2": "SUITE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051636",
            "telephone_number": "205-939-3000",
            "fax_number": "205-930-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 SAINT VINCENTS DR",
            "address_2": "SUITE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051636",
            "telephone_number": "205-939-3699",
            "fax_number": "205-939-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBURN",
        "first_name": "KIMBRELL",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42595",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51527784",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Jay Coker, M.D.
• Breanna Coker
• Henry Benjamin Coker IV, DO
• Ricardo E. Colberg, MD
• Jane McGee Colburn, O.T,L.
• Elaine Marie Colby, MD
• Garrett Walker Colby, MD
• Cole Vision Corporation
• Alice Cole
• Amanda Barnett Cole, MS OTRL

• Surgical Physician Assistant in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Surgical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.