Active NPI
Teresa R Funderburg, R.D.
- Registered Dietitian
- Birmingham, AL
National Provider Identifier
1063605376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1240
- Practice address
- 3341 Spring Valley CT
Birmingham, AL 35223-2006 - Phone
- (205) 967-3772
- NPI assigned
- Aug 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1240 | AL | Primary |
Addresses
Primary practice location
3341 Spring Valley CT
Birmingham, AL 35223-2006
Mailing address
3341 Spring Valley CT
Birmingham, AL 35223-2006
Phone (205) 967-3772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1240 | AL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187740800000",
"number": "1063605376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3341 SPRING VALLEY CT",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352232006",
"telephone_number": "205-967-3772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3341 SPRING VALLEY CT",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352232006",
"telephone_number": "205-967-3772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNDERBURG",
"first_name": "TERESA",
"middle_name": "R",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-20",
"last_updated": "2007-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AL",
"license": "1240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.