Individual provider Active NPI

Charles Kirkland II, M.D.

  • Family Medicine Physician
  • Fairhope, AL
National Provider Identifier
1669646147
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29930 Issued in AL
Practice address
21950 State Highway 181 Ste a
Fairhope, AL 36532-4393
Phone
(251) 621-6520
Fax
(251) 621-6521
NPI assigned
Apr 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29930 AL Primary

Addresses

Primary practice location

21950 State Highway 181 Ste a
Fairhope, AL 36532-4393

Mailing address

PO Box 749429
Atlanta, GA 30374-9429
Phone (251) 621-6520

Other identifiers 1

IdentifierTypeStateIssuer
A151776148OtherALMEDICARE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110823000433 AL Practitioner - Family Practice 8729258165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Alabama College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
USA Health Daphne Family Practice LLCGroup PAC ID 7618362948, 8 clinicians

Practice addresses (Care Compare)

21950 State Hwy 181
Suite A1
Fairhope, AL 36532-4393
Phone (251) 621-6520

Hospital & facility affiliations

  • Thomas Hospital Hospital, Fairhope, AL, CCN 010100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Daphne Family Practice, LLC Family Medicine CurrentSince Apr 1, 2022 Accepting new patients

Locations

27961 US Highway 98
Ste 20
Daphne, AL 36526
Phone (251) 621-6520

21950 State Highway 181
Ste A
Fairhope, AL 36532
Phone (251) 621-6520

21950 State Highway 181
Fairhope, AL 36532
Phone (251) 410-5437

21950 State Highway 181
Ste A1
Fairhope, AL 36532
Phone (251) 621-6520

Interoperability endpoints

  • Direct secure messaging: charleskirkland@daphnefami.allscriptsdirect.net

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 1

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1669646147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749429",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749429",
            "telephone_number": "251-621-6520",
            "fax_number": "251-621-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21950 STATE HIGHWAY 181 STE A",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365324393",
            "telephone_number": "251-621-6520",
            "fax_number": "251-621-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "CHARLES",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "29930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A151776148",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.