Active NPI
Shelley Moreland, FNP-C
- Family Nurse Practitioner
- Birmingham, AL
National Provider Identifier
1073974556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-111866
- Practice address
- 2660 10TH Ave S
#610
Birmingham, AL 35205-1605 - Phone
- (205) 933-2691
- Fax
- (205) 933-2350
- NPI assigned
- Mar 11, 2016
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-111866 | AL | Primary |
Addresses
Primary practice location
2660 10TH Ave S
#610
Birmingham, AL 35205-1605
Mailing address
2660 10TH Ave S
#610
Birmingham, AL 35205-1605
Phone (205) 933-2691
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538255922 | Medicaid | AL | |
| 1-111866 | Other | AL | RN LICENSE NUMBER |
| 5465 | Other | AL | CRNP RX NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-111866 | AL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical West Hospital Authority, an Affiliate of Uab Health System | Past | Accepting new patients | |
| Alabama Digestive Diseases PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Medical Specialty Clinic/Center
- Birmingham, AL
- NPI 1265893002
-
- Multi-Specialty Clinic/Center
- Bessemer, AL
- NPI 1952483729
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1073974556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2660 10TH AVE S",
"address_2": "#610",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352051605",
"telephone_number": "205-933-2691",
"fax_number": "205-933-2350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2660 10TH AVE S",
"address_2": "#610",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352051605",
"telephone_number": "205-933-2691",
"fax_number": "205-933-2350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORELAND",
"first_name": "SHELLEY",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-11",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-111866",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1538255922",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE NUMBER",
"identifier": "1-111866",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNP RX NUMBER",
"identifier": "5465",
"state": "AL"
}
],
"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 Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.