KENNIETH CHARLES JR. MCCOLLOUGH (M.D.) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1720243421
Sports Medicine (Orthopaedic Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
112 SPORTS MEDICINE in AL
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Provider Addresses for KENNIETH CHARLES JR. MCCOLLOUGH (M.D.)
11th Avenue South, Woodlawn Heights, Birmingham, Jefferson County, Alabama, 35222, United States
BIRMINGHAM, AL 35205
Phone: (205) 930-8339
Type: Location
PO BOX 55310
BIRMINGHAM, AL 352555310
Phone:
Type: Mailing
120 S Anniston Ave
Sylacauga, AL 351502904
Phone: (256) 245-3201
Fax: (256) 245-4112
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-07-15
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110823000536 | I | Orthopedic Surgery | AL | TBD |
| I20220715001468 | I | Sports Medicine | MS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16 | 15 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 15 | 12 | $0 |
Insurance plans in this area (ZIP 35205)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MS | |
| Nurse Practitioner | MS | |
| Family Practice | MS | |
| Family Practice | MS | |
| - | MS |
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