Keller Shoals Urological Associates

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

KELLER SHOALS UROLOGICAL ASSOCIATES

Practice address

1015 S Jackson Hwy
Sheffield, AL 35660-5760

Phone

(256) 381-5510

NPI assigned

Nov 26, 2024

Organization subpart

No

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

Authorized official

Name

Carrie Vanetten

Title

Insurance Manager

Phone

(256) 381-5510

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Practitioners 4

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

• Mark Walker Smith, M.D.

  • Specialist
  • Sheffield, AL
  • NPI 1396715843
  Medicare reassignment NPD
• Frederick Larry Holcomb, M.D.

  • Specialist
  • Sheffield, AL
  • NPI 1477523272
  NPD
• Kevin Michael Walls, M.D.

  • Urology Physician
  • Sheffield, AL
  • NPI 1295908507
  NPD
• Michael Robert Yordy, M.D.

  • Specialist
  • Sheffield, AL
  • NPI 1730159112
  NPD

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1740006568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S JACKSON HWY",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356605760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S JACKSON HWY",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356605760",
            "telephone_number": "256-381-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLER SHOALS UROLOGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "VANETTEN",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "256-381-5510"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A Kassels, MD
• Alice Susan Keeton, CRNP
• Mary Irene Kehoe, CRNP
• Keller Anesthesia Services
• Keller Hospitalist Services
• Drew Steven Kellough, LICSW
• Mike Kessler, RPH
• Saira Khan, FNP
• Joseph M Kim, MD
• Matthew King, NP

• Urology Physician in Sheffield, AL
• Providers in Sheffield, AL by specialty
• Urology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.