Individual provider Active NPI

Kenneth R Dreibelbis Jr., PA-C

  • Medical Physician Assistant
  • Mobile, AL
National Provider Identifier
1962433862
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-19 Issued in AL
Practice address
101 Memorial Hospital Dr Ste 200
Mobile, AL 36608-1787
Phone
(251) 414-5900
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA-19 AL Primary

Addresses

Primary practice location

101 Memorial Hospital Dr Ste 200
Mobile, AL 36608-1787

Mailing address

101 Memorial Hospital Dr
Suite200
Mobile, AL 36608-1784
Phone (251) 414-5900

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
I20060908000265 AL Practitioner - Physician Assistant 2668476409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alabama Medical Group PCGroup PAC ID 6709152499, 42 clinicians

Practice addresses (Care Compare)

101 Memorial Hospital Dr
Suite 200
Mobile, AL 36608-1787
Phone (251) 414-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-19ALMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Center LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kennethdreibelbis@amgmd.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1962433862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MEMORIAL HOSPITAL DR",
            "address_2": "SUITE200",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081784",
            "telephone_number": "251-414-5900",
            "fax_number": "251-281-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEMORIAL HOSPITAL DR STE 200",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081787",
            "telephone_number": "251-414-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREIBELBIS",
        "first_name": "KENNETH",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.