Organization Active NPI

Lumina LLC

  • Pediatric Otolaryngology Physician
  • Birmingham, AL
National Provider Identifier
1750700175
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
22947 Issued in AL
Legal business name
LUMINA LLC
Practice address
5406 U.S. Highway 280
Suite A101
Birmingham, AL 35242
Phone
(205) 874-9436
Fax
(205) 874-9438
NPI assigned
Apr 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Jacob French
Title
Office Manager
Phone
(205) 874-9436

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YP0228X 22947 AL Primary

Addresses

Primary practice location

5406 U.S. Highway 280
Suite A101
Birmingham, AL 35242

Mailing address

5406 U.S. Highway 280
Suite A101
Birmingham, AL 35242
Phone (205) 874-9436

Other identifiers 1

IdentifierTypeStateIssuer
22947MedicaidAL

Other names 1

  • ENT for Kids Alabama Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140702000179 AL Part B Supplier - Clinic/Group Practice 6305061508 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, AL

National Provider Directory

National Provider Directory

Locations

5406 Highway 280
Ste A101
Hoover, AL 35242
Phone (205) 874-9436

2807 Greystone Commercial Blvd
Ste 42
Hoover, AL 35242
Phone (205) 383-6890

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1750700175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 U.S. HIGHWAY 280",
            "address_2": "SUITE A101",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35242",
            "telephone_number": "205-874-9436",
            "fax_number": "205-874-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 U.S. HIGHWAY 280",
            "address_2": "SUITE A101",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35242",
            "telephone_number": "205-874-9436",
            "fax_number": "205-874-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "FRENCH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "205-874-9436"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "AL",
            "license": "22947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22947",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENT for Kids Alabama",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ENT for Kids Alabama",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.