Keegan John Nicodemus, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD.41880 Issued in AL

Practice address

1802 6TH Ave S
Birmingham, AL 35233-1932

Phone

(205) 934-4011

NPI assigned

Mar 25, 2019

Last updated

Jan 15, 2026By 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

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

Specialty

Emergency Medicine

Education

Medical College of Georgia School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Emergency Physicians, LLCGroup PAC ID 7911909973, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grandview Medical Center Hospital, Birmingham, AL, CCN 010104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Trinity Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1487669016
  Medicare reassignment Care Compare group NPD
• Ess of Luverne LLC

  • Emergency Medicine Physician
  • Luverne, AL
  • NPI 1457953473
  Medicare reassignment NPD
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459
  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• Trinity Emergency Physicians LLC

  • Emergency Medicine Physician
  • Trussville, AL
  • NPI 1326750589
  NPD

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

• Affinity Hospital LLC

  dba Grandview Medical Center

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1023061405
  Care Compare affiliation

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1972063824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331932",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-975-7387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICODEMUS",
        "first_name": "KEEGAN",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD.41880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey K Nicholson, MD
• Niesha Nicholson
• William Nicholson, MSN, CRNP
• Robert John Nicke, M.D., J.D., M.B.A.
• William B Nickell, M,D.
• Yostina Marie Nicola, DMD
• Nicolas Brown, DMD General Dentistry, LLC
• John Victor Nicolini, MSW
• Krista Niedermeier
• Amanda Niedfeld

• Emergency Medicine Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Emergency Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.