Individual provider Active NPI

Megan Kelly

  • Registered Nurse
  • Vestavia Hills, AL
National Provider Identifier
1639762404
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1-147368 Issued in AL
Practice address
1205 Wickford Rd
Vestavia Hills, AL 35216-2320
Phone
(205) 516-6432
NPI assigned
Feb 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-147368 AL Primary

Addresses

Primary practice location

1205 Wickford Rd
Vestavia Hills, AL 35216-2320

Mailing address

1205 Wickford Rd
Vestavia Hills, AL 35216-2320
Phone (205) 516-6432

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
I20221229001892 AL Practitioner - Nurse Practitioner 5799155107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-147368ALMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Dec 1, 2022 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

Organizations & group practices 1

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.

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": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1639762404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 WICKFORD RD",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352162320",
            "telephone_number": "205-516-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 WICKFORD RD",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352162320",
            "telephone_number": "205-516-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MEGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-147368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestavia Hills, AL

Sources for this page

Verify at the official NPI Registry.