Jennifer Riedel Brockington, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO.2973 Issued in AL

Practice address

1308 Tuscaloosa Ave SW
Birmingham, AL 35211-1948

Phone

(205) 679-6325

Fax

(205) 783-8600

NPI assigned

May 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.brockington.1@11347.direct.athenahealth.com

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.

• Cahaba Medical Care Foundation

  • Federally Qualified Health Center (FQHC)
  • Centreville, AL
  • NPI 1316201809
  Medicare reassignment NPD
• Cahaba Medical Care Foundation

  • Federally Qualified Health Center (FQHC)
  • Centreville, AL
  • NPI 1316542624
  NPD

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1558653790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BELCHER ST",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "350422946",
            "telephone_number": "205-926-2992",
            "fax_number": "205-316-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 TUSCALOOSA AVE SW",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111948",
            "telephone_number": "205-679-6325",
            "fax_number": "205-783-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKINGTON",
        "first_name": "JENNIFER",
        "middle_name": "RIEDEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-06",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P8862",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.2973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Alan Brock, MD
• Paula Freeburg Brock, CRNA
• Robert I Brock, MD
• Shawnneice Beth Brock, MSW, LICSW, PIP
• Jared Scott Brockington, D.O.
• Amy E Brockway
• Sarah G Brockway
• Leah Ann Brodbeck, PSYD
• Jillian Paige Brodeur, CRNP
• Abigayle Faith Brodie, PHARMD

• Family Medicine Physician in Birmingham, AL
• Providers in Birmingham, 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 Aug 31, 2022; 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.