Peter Kinnebrew, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

22185 Issued in AL

Practice address

13596 Hwy 231 431 N
Suite 2
Hazel Green, AL 35750-8642

Phone

(256) 828-2094

Fax

(256) 828-0526

NPI assigned

Jan 4, 2006

Last updated

Sep 3, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283472000000",
    "number": "1861470445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13596 HWY 231 431 N",
            "address_2": "SUITE 2",
            "city": "HAZEL GREEN",
            "state": "AL",
            "postal_code": "357508617",
            "telephone_number": "256-828-2094",
            "fax_number": "256-828-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13596 HWY 231 431 N",
            "address_2": "SUITE 2",
            "city": "HAZEL GREEN",
            "state": "AL",
            "postal_code": "357508642",
            "telephone_number": "256-828-2094",
            "fax_number": "256-828-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEBREW",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2010-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "AL",
            "license": "22185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51045542",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009981810",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Home Sweet Home Nal LLC
• Alyson Justice, CRNP
• David Adam Kelly, PHARMD
• Shayna Spearman Kidd, FNP
• Mary C Kimbrell, CRNP
• Dawn M Kumber-Curry
• Laura Lee Taylor M.D.,LLC (The Doctor's Office)
• Sarah Lee
• Griffin Keith Lewallen, PT
• Sidney Earl Lyle, RPH

• Pediatric Adolescent Medicine Physician in Hazel Green, AL
• Providers in Hazel Green, AL by specialty
• Pediatric Adolescent Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.