Individual provider Active NPI

Kaitlyn Traywick Pierce

  • Adult Health Nurse Practitioner
  • Pell City, AL
National Provider Identifier
1790243582
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1-161924 Issued in AL
Practice address
70 Plaza Dr
Pell City, AL 35125-9314
Phone
(205) 814-9284
Fax
(205) 814-9626
NPI assigned
Mar 11, 2019
Last updated
Sep 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-161924 AL Primary
Registered Nurse 163W00000X 1-161924 AL

Addresses

Primary practice location

70 Plaza Dr
Pell City, AL 35125-9314

Mailing address

70 Plaza Dr
Pell City, AL 35125-9314
Phone (205) 814-9284

Other practice location 1

1802 6th Ave S
Birmingham, AL 35233-1932
Phone (205) 934-4206

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201228000435 AL Practitioner - Nurse Practitioner 7911319504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Birmingham Internal Medicine Associates, LLCGroup PAC ID 1658341193, 123 clinicians

Practice addresses (Care Compare)

7191 Cahaba Valley Rd
Suite 300
Hoover, AL 35242-6461
Phone (205) 814-7206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-161924ALMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Birmingham Internal Medicine Associates, LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

7191 Cahaba Valley Rd
Ste 300
Hoover, AL 35242
Phone (205) 930-2060

70 Plaza Dr
Pell City, AL 35125
Phone (205) 814-9284

74 Plaza Dr
Pell City, AL 35125
Phone (205) 814-7272

Interoperability endpoints

  • Direct secure messaging: kaitlyn.pierce.1@15135.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1790243582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 PLAZA DR",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351259314",
            "telephone_number": "205-814-9284",
            "fax_number": "205-814-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PLAZA DR",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351259314",
            "telephone_number": "205-814-9284",
            "fax_number": "205-814-9626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 6th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331932",
            "country_code": "US",
            "telephone_number": "205-934-4206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "KAITLYN",
        "middle_name": "TRAYWICK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-161924",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-161924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pell City, AL

Sources for this page

Verify at the official NPI Registry.