Michelle Blackburn Kalousek

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-123866 Issued in AL

Practice address

960 Rocket Way
Gardendale, AL 35071-4749

Phone

(205) 263-0952

NPI assigned

Dec 14, 2020

Last updated

Jan 31, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vincentian Physician Services LLCGroup PAC ID 1557548161, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mblackburn@direct.uabmedicine.org
• Direct secure messaging: michelle.kalousek.1@9069.direct.athenahealth.com

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.

• Vincentian Physician Services LLC

  • Family Medicine Physician
  • Birmingham, AL
  • NPI 1851698310
  Medicare reassignment Care Compare group NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1013503127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 KERRY DOWNS RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352423906",
            "telephone_number": "205-999-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 ROCKET WAY",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350714749",
            "telephone_number": "205-263-0952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "960 Rocket Way",
            "address_purpose": "LOCATION",
            "city": "Gardendale",
            "state": "AL",
            "postal_code": "350714749",
            "country_code": "US",
            "telephone_number": "205-263-0952",
            "fax_number": "205-975-6424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "960 Rocket Way",
            "address_purpose": "LOCATION",
            "city": "Gardendale",
            "state": "AL",
            "postal_code": "350714749",
            "country_code": "US",
            "telephone_number": "205-263-0952",
            "fax_number": "205-975-6424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALOUSEK",
        "first_name": "MICHELLE",
        "middle_name": "BLACKBURN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2024-01-31",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-123866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mblackburn@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "960 Rocket Way",
            "city": "Gardendale",
            "state": "AL",
            "country_code": "US",
            "postal_code": "350714749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mblackburn@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "960 Rocket Way",
            "city": "Gardendale",
            "state": "AL",
            "country_code": "US",
            "postal_code": "350714749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mitchell G Jones, PA-C
• Roxgena Jones, OTR/L
• Gabrielle A Joseph
• Yogini R Jotani
• Griffin Just
• Marti Kaple
• Sarah Margaret Keaten
• Julia Keenum, OTD
• Danielle Leigh Kelley
• Cherry Kelly, PHARM.D.

• Family Nurse Practitioner in Gardendale, AL
• Providers in Gardendale, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.