NPIMap

Organization Active NPI

K2S2 Management, LLC

  • Internal Medicine Physician
  • Homewood, AL
National Provider Identifier
1881102135
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
K2S2 MANAGEMENT, LLC
Practice address
3800 Ridgeway Dr
Homewood, AL 35209-5506
Phone
(205) 868-2000
NPI assigned
Jan 19, 2018
Last updated
Jan 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Authorized official

Name
Kyle Rudemiller, MDNPI 1306136692
Title
Owner
Phone
(205) 655-2088

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

3800 Ridgeway Dr
Homewood, AL 35209-5506

Mailing address

PO Box 296
Shannon, AL 35142-0296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180716000853 AL Part B Supplier - Clinic/Group Practice 6305193822 Receives reassigned benefits from 17 practitioners
Practice locations: Birmingham, AL; Homewood, AL; Pelham, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516320000000",
    "number": "1881102135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 296",
            "city": "SHANNON",
            "state": "AL",
            "postal_code": "351420296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RIDGEWAY DR",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352095506",
            "telephone_number": "205-868-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K2S2 MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A",
        "authorized_official_last_name": "RUDEMILLER",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-655-2088",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; 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.