DRS. Ketcham and Dismukes

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2802 Issued in AL

Legal business name

DRS. KETCHAM AND DISMUKES

Practice address

202 Hwy 80 E
Demopolis, AL 36732

Phone

(334) 289-0499

Fax

(334) 289-3013

NPI assigned

Mar 19, 2007

Organization subpart

No

Name

Mrs. Linda Smith Mayton

Title

Billing Manager

Phone

(334) 289-0499

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith Alan Dismukes, MD

  • Family Medicine Physician
  • Demopolis, AL
  • NPI 1295749059

  Family Medicine

  NPD

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 10, 2009.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1720102387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 HWY 80 E",
            "address_2": "P.O. BOX 650",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "36732",
            "telephone_number": "334-289-0499",
            "fax_number": "334-289-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 HWY 80 E",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "36732",
            "telephone_number": "334-289-0499",
            "fax_number": "334-289-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. KETCHAM AND DISMUKES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "MAYTON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "334-289-0499",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "2802",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000088680",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0110356",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000088681",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0110247",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051088680",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "051088681",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Demopolis Pediatrics
• Keith Alan Dismukes, MD
• Dr Keith Dismukes L.L.C.
• Dr. Nakieta M. Lankster LLC
• James Daniel Dreading, D.M.D.
• Dva Healthcare Renal Care Inc
• Dana Eddins, MS, CCC-SLP
• Sharon Edmondson, PHARMD
• Kelly A Epting, PT
• Fernando Alegria, MD, LLC

• All providers in Demopolis, AL
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.