Individual provider Active NPI

Kevin McGowin Schambeau, D.M.D.

  • General Practice Dentistry
  • Bessemer, AL
National Provider Identifier
1508803735
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4737 Issued in AL
Practice address
6260 Park South Dr
Suite 101
Bessemer, AL 35022-5655
Phone
(205) 428-2205
Fax
(205) 428-9287
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4737 AL Primary

Addresses

Primary practice location

6260 Park South Dr
Suite 101
Bessemer, AL 35022-5655

Mailing address

6260 Park South Dr
Suite 101
Bessemer, AL 35022-5655
Phone (205) 428-2205

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120614000015 AL Practitioner - Oral Surgery 5799949277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1508803735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6260 PARK SOUTH DR",
            "address_2": "SUITE 101",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350225655",
            "telephone_number": "205-428-2205",
            "fax_number": "205-428-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 PARK SOUTH DR",
            "address_2": "SUITE 101",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350225655",
            "telephone_number": "205-428-2205",
            "fax_number": "205-428-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAMBEAU",
        "first_name": "KEVIN",
        "middle_name": "MCGOWIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bessemer, AL

Sources for this page

Verify at the official NPI Registry.