Ricky L Fennell, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

21526 Issued in AL

Practice address

619 19TH Street South
Birmingham, AL 35233

Phone

(205) 934-4011

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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 Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Arrington Valley Healthcare, Inc.

  • Skilled Nursing Facility
  • Birmingham, AL
  • NPI 1982597456

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership

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.

• Fennell Medical Services, LLC

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1083730519
  Medicare reassignment NPD Authorized official
• Pai Participant 1 LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1093371312

  AL

  Medicare reassignment NPD
• Ball Healthcare Eastview Inc

  • Skilled Nursing Facility
  • Birmingham, AL
  • NPI 1275569873
  NPD (past)
• Ball Healthcare-Jefferson, Inc.

  • Skilled Nursing Facility
  • Birmingham, AL
  • NPI 1891730438
  NPD (past)
• BHC - Bessemer

  • Specialist
  • Bessemer, AL
  • NPI 1255395471
  NPD (past)
• Civic Center Health and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Birmingham, AL
  • NPI 1255387379
  NPD (past)
• Northway Health and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Birmingham, AL
  • NPI 1811943152
  NPD (past)
• Simon-Williamson Clinic, P.C.

  • Internal Medicine Physician
  • Birmingham, AL
  • NPI 1497702344

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1689618357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310",
            "telephone_number": "205-731-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH STREET SOUTH",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35233",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "RICKY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "21526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00101365",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009947355",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051520885",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fellowship House, Inc.
• Sheila Renae Fells, CRNP
• Elizabeth Hope Felsinger, RN
• April Marie Felton, ARNP
• Fennell Medical Services, LLC
• Andrea Fenton
• Ashley Ferguson, MA, LPC
• Caroline Elizabeth Ferguson
• Charles Baron Ferguson, CRNA
• Courtney Ferguson, CRNA

• Cardiovascular Disease Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Cardiovascular Disease Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.