Kenneth Obiefuna Kenneth-Nwosa, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

MD.41196 Issued in AL

Practice address

805 Saint Vincents Dr Ste 100
Birmingham, AL 35205-1638

Phone

(205) 939-3699

Fax

(205) 581-7155

NPI assigned

Jun 27, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Sports MedicineAlso: Family Practice

Education

University of Texas Medical Branch at Galveston, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

TMC Provider Group PLLCGroup PAC ID 6305149121, 213 clinicians

University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health San Antonio Multispecialty & Research Ho Hospital, San Antonio, TX, CCN 670335

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkennethnwosa32863@direct.utmsa.com

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

• TMC Provider Group PLLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1053784660
  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at San Antonio

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717

  Family Medicine

  Medicare reassignment Care Compare group NPD
• American Family Care, LLC

  • Primary Care Clinic/Center
  • Birmingham, AL
  • NPI 1669429080
  Medicare reassignment NPD
• STV Sports Medicine & Orthopedics LLC

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Birmingham, AL
  • NPI 1467818575
  Medicare reassignment NPD
• American Family Care, LLC

  • Family Medicine Physician
  • Vestavia Hills, AL
  • NPI 1265210645
  NPD
• STV Sports Medicine & Orthopedics LLC

  • Durable Medical Equipment & Medical Supplies
  • Pelham, AL
  • NPI 1770365504
  NPD
• The University of Texas Health Science Center at San Antonio

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• TMC Provider Group PLLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1033968789
  NPD
• TMC Provider Group PLLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1689039471

  Family Medicine

  NPD
• University of Texas Health Science Center at San Antonio

  • Diagnostic Radiology Physician
  • Boerne, TX
  • NPI 1417921834
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The University of Texas Health Science Center at San Antonio

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  Care Compare affiliation

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1851811186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SAINT VINCENTS DR STE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051638",
            "telephone_number": "205-939-3699",
            "fax_number": "205-581-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 SAINT VINCENTS DR STE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051638",
            "telephone_number": "205-939-3699",
            "fax_number": "205-581-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNETH-NWOSA",
        "first_name": "KENNETH",
        "middle_name": "OBIEFUNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-27",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.41196",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AL",
            "license": "MD.41196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Ellis Kennedy, MD
• Salee Elizabeth Kennedy, RN
• Timothy Irving Kennell Jr., MD
• Kenneth Mark Middlebrooks MD PC
• Kenneth R. Smith, P.C.
• Hailey Ann Kennett, RN
• Jordan Nicole Kennon, PSYD
• Heather H Kent, CRNA
• Katherine Kent
• Kayla Kent

• Sports Medicine (Family Medicine) Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Sports Medicine (Family Medicine) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.