NPIMap

Organization Active NPI

Jefferson-Blount-St. Clair MH/Mr Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Birmingham, AL
National Provider Identifier
1073610499
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
JEFFERSON-BLOUNT-ST. CLAIR MH/MR AUTHORITY
Practice address
940 Montclair Rd
Suite 200
Birmingham, AL 35213-1217
Phone
(205) 595-4555
Fax
(205) 592-3539
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Dr. Richard Craig, PH.D.NPI 1871632703
Title
Executive Director
Phone
(205) 595-4555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X AL
Developmentally Disabled Services Day Training Agency 251C00000X AL
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X AL Primary
Mental Illness Community Based Residential Treatment Facility 320800000X AL
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X AL

Addresses

Primary practice location

940 Montclair Rd
Suite 200
Birmingham, AL 35213-1217

Mailing address

940 Montclair Rd
Suite 200
Birmingham, AL 35213-1217
Phone (205) 595-4555

Other identifiers 5

IdentifierTypeStateIssuer
330000017MedicaidAL
590000017MedicaidAL
51008104OtherALBCBS ALL KIDS BASIC NUMBER
008506000MedicaidAL
330034017MedicaidAL

Other names 1

  • JBS MH/MR Authority Other name

National Provider Directory

National Provider Directory
Tax ID family
Jeff Blount St Clair MNTL2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1073610499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 MONTCLAIR RD",
            "address_2": "SUITE 200",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352131217",
            "telephone_number": "205-595-4555",
            "fax_number": "205-592-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 MONTCLAIR RD",
            "address_2": "SUITE 200",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352131217",
            "telephone_number": "205-595-4555",
            "fax_number": "205-592-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON-BLOUNT-ST. CLAIR MH/MR AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-595-4555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AL",
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330000017",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590000017",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ALL KIDS BASIC NUMBER",
            "identifier": "51008104",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008506000",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330034017",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JBS MH/MR Authority",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.