Individual provider Active NPI

Kim Rudolph McGlothan, M.D.

  • Nephrology Physician
  • Montgomery, AL
National Provider Identifier
1962629915
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
31714 Issued in AL
Practice address
4760 Woodmere Blvd
Montgomery, AL 36106-3065
Phone
(334) 288-0814
Fax
(334) 288-3417
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 31714 AL Primary

Addresses

Primary practice location

4760 Woodmere Blvd
Montgomery, AL 36106-3065

Mailing address

4760 Woodmere Blvd
Montgomery, AL 36106-3065
Phone (334) 288-0814

Other names 1

  • Kim La'Chet Rudolph Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120725000894 AL Practitioner - NephrologyPractitioner - Internal Medicine 5395901946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renal Associates of Montgomery, P.C.Group PAC ID 6608894019, 9 clinicians

Practice addresses (Care Compare)

1412 Elba Hwy
Troy, AL 36079-6020
Phone (334) 288-0814

44 Medical Arts CT
Greenville, AL 36037-3869
Phone (334) 288-0814

4760 Woodmere Blvd
Montgomery, AL 36106-3065
Phone (334) 288-0814

556 McQueen Smith Rd N
Prattville, AL 36066-5558
Phone (334) 288-0814

Hospital & facility affiliations

  • FMC of Taylor Road Dialysis facility, Montgomery, AL, CCN 012654
  • FMC Tallassee Dialysis facility, Tallassee, AL, CCN 012680
  • Baptist Medical Center South Hospital, Montgomery, AL, CCN 010023
  • Baptist Medical Center East Hospital, Montgomery, AL, CCN 010149
  • Prattville Baptist Hospital Hospital, Prattville, AL, CCN 010108
  • Jackson Hospital & Clinic Inc Hospital, Montgomery, AL, CCN 010024
  • The Health Care Authority of the City of Greenville- LV Stabler Hospital Hospital, Greenville, AL, CCN 010150
  • Encompass Rehabilitation Hospital of Montgomery Inpatient rehabilitation facility, Montgomery, AL, CCN 013028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31714ALMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Associates of Montgomery, P.C. Nephrology CurrentSince Jun 19, 2012 Accepting new patients

Locations

350 Paul Stabler Dr
Greenville, AL 36037
Phone (334) 383-0006

4760 Woodmere Blvd
Montgomery, AL 36106
Phone (334) 288-0814

1412 Elba Hwy
Troy, AL 36079
Phone (334) 288-0814

606 Botts Ave
Troy, AL 36081
Phone (334) 434-5193

Interoperability endpoints

  • Direct secure messaging: kim.mcglothan@ram.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HGHAAA
  • Direct secure messaging: kim.mcglothan@direct.baptistfirst.org

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1962629915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063065",
            "telephone_number": "334-288-0814",
            "fax_number": "334-288-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063065",
            "telephone_number": "334-288-0814",
            "fax_number": "334-288-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLOTHAN",
        "first_name": "KIM",
        "middle_name": "RUDOLPH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "31714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "RUDOLPH",
            "middle_name": "LA'CHET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.