Active NPI
Keith Canfield Silliman, O.D.
- Optometrist
- Birmingham, AL
National Provider Identifier
1770686776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- S-928-TA-495
- Practice address
- 2870 Old Rocky Ridge Rd
Suite 106
Birmingham, AL 35243-2927 - Phone
- (205) 824-1257
- Fax
- (205) 824-3629
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | S-928-TA-495 | AL | Primary |
Addresses
Primary practice location
2870 Old Rocky Ridge Rd
Suite 106
Birmingham, AL 35243-2927
Mailing address
2229 Blue Ridge Blvd
Birmingham, AL 35226-3133
Phone (205) 979-6152
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51060858 | Other | AL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120217000018 | AL | Practitioner - Optometry | 3870751142 | Practice locations: Birmingham, AL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S-928-TA-495 | AL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770686776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2229 BLUE RIDGE BLVD",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352263133",
"telephone_number": "205-979-6152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2870 OLD ROCKY RIDGE RD",
"address_2": "SUITE 106",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352432927",
"telephone_number": "205-824-1257",
"fax_number": "205-824-3629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SILLIMAN",
"first_name": "KEITH",
"middle_name": "CANFIELD",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AL",
"license": "S-928-TA-495",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "51060858",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.