Organization Active NPI

Kibun Health PLLC

  • Clinic/Center
  • Birmingham, AL
National Provider Identifier
1811688021
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
KIBUN HEALTH PLLC
Practice address
2236 Cahaba Valley Dr Ste 206a
Birmingham, AL 35242-2625
Phone
(205) 583-6661
NPI assigned
May 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Authorized official

Name
Phillip SmithNPI 1427404193
Title
Dir.
Phone
(205) 583-6661

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

2236 Cahaba Valley Dr Ste 206a
Birmingham, AL 35242-2625

Mailing address

PO Box 18957
Charlotte, NC 28218-0957

Other practice location 1

4108 Park Rd Ste 321
Charlotte, NC 28209-2259
Phone (205) 583-6661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, SC, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20230725001411 AL Part B Supplier - Clinic/Group Practice 9931560836 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, AL
O20230927002578 SC Part B Supplier - Clinic/Group Practice 9931560836 Receives reassigned benefits from 1 practitioner
Practice locations: Hilton Head Island, SC
O20250814001623 NC Part B Supplier - Clinic/Group Practice 9931560836 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

2236 Cahaba Valley Dr
Ste 206A
Birmingham, AL 35242
Phone (205) 583-6661

4108 Park Rd
Ste 321
Charlotte, NC 28209
Phone (205) 583-6661

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756166400000",
    "number": "1811688021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18957",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282180957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 CAHABA VALLEY DR STE 206A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422625",
            "telephone_number": "205-583-6661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4108 Park Rd Ste 321",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282092259",
            "country_code": "US",
            "telephone_number": "205-583-6661",
            "fax_number": "617-362-2499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIBUN HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-18",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "DIR.",
        "authorized_official_telephone_number": "205-583-6661"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Aug 26, 2025; 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.