Kenneth Mark Middlebrooks MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

207RI0200X Issued in AL

Legal business name

KENNETH MARK MIDDLEBROOKS MD PC

Practice address

100 Pilot Medical Drive
Suite 125
Birmingham, AL 35235-3430

Phone

(205) 380-0848

NPI assigned

Aug 11, 2006

Organization subpart

No

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

Authorized official

Name

Kim York

Title

Billing and Credentialing

Phone

(205) 854-1111

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1700897816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PILOT MEDICAL DRIVE",
            "address_2": "SUITE 125",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353430",
            "telephone_number": "205-380-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PILOT MEDICAL DRIVE",
            "address_2": "SUITE 125",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353430",
            "telephone_number": "205-380-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH MARK MIDDLEBROOKS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "BILLING AND CREDENTIALING",
        "authorized_official_telephone_number": "205-854-1111"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "207RI0200X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000089762",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1891742706",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mallory Kennedy
• Melanie J. Kennedy, LPC
• Richard Ellis Kennedy, MD
• Salee Elizabeth Kennedy, RN
• Timothy Irving Kennell Jr., MD
• Kenneth R. Smith, P.C.
• Kenneth Obiefuna Kenneth-Nwosa, MD
• Hailey Ann Kennett, RN
• Jordan Nicole Kennon, PSYD
• Heather H Kent, CRNA

• Specialist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.