Active NPI
Klaus Medenbach, MD
- Urology Physician
- Decatur, AL
National Provider Identifier
1659582658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 8696
- Practice address
- 1107 14TH Ave SE
Suite G200
Decatur, AL 35601-3309 - Phone
- (256) 353-0605
- Fax
- (256) 353-0618
- NPI assigned
- May 24, 2007
- Last updated
- Jan 4, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 8696 | AL | Primary |
Addresses
Primary practice location
1107 14TH Ave SE
Suite G200
Decatur, AL 35601-3309
Mailing address
1107 14TH Ave SE
Suite G200
Decatur, AL 35601-3309
Phone (256) 353-0605
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8696 | AL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Decatur General Hospital | Urology | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262563200000",
"number": "1659582658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 14TH AVE SE",
"address_2": "SUITE G200",
"city": "DECATUR",
"state": "AL",
"postal_code": "356013309",
"telephone_number": "256-353-0605",
"fax_number": "256-353-0618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 14TH AVE SE",
"address_2": "SUITE G200",
"city": "DECATUR",
"state": "AL",
"postal_code": "356013309",
"telephone_number": "256-353-0605",
"fax_number": "256-353-0618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDENBACH",
"first_name": "KLAUS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2010-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "AL",
"license": "8696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.