NPIMap

Individual provider Active NPI

Jurwardolyn Adaira Shuford-Guice, CRNP

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1114244456
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-096626 Issued in AL
Practice address
2060 Berryhill Rd
Montgomery, AL 36117-3599
Phone
(334) 676-3366
Fax
(334) 676-3367
NPI assigned
Apr 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-096626 AL Primary

Addresses

Primary practice location

2060 Berryhill Rd
Montgomery, AL 36117-3599

Mailing address

PO Box 241587
Montgomery, AL 36124-1587
Phone (334) 280-1500

Other practice location 1

273 Winton M Blount Loop
Montgomery, AL 36117-3507
Phone (334) 280-1500

Other practice location 2

1758 Park Pl Ste 402
Montgomery, AL 36106-1135
Phone (334) 293-6842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110725000233 AL Practitioner - Nurse Practitioner 3173791852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Region Dermatology and Laser IncGroup PAC ID 3678867736, 3 clinicians

Practice addresses (Care Compare)

2060 Berryhill Rd
Montgomery, AL 36117-3599
Phone (334) 676-3366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-096626ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital and Clinic, Inc. Current Accepting new patients
Jackson Hospital & Clinic, Inc. CurrentSince Feb 22, 2017 Accepting new patients
River Region Dermatology and Laser Inc CurrentSince Nov 1, 2019 Accepting new patients
Jackson Hospital and Clinic, Inc. CurrentSince Feb 22, 2017 Accepting new patients

Locations

1758 Park Pl
Ste 402
Montgomery, AL 36106
Phone (334) 265-7255

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1801 Pine St
Ste 103
Montgomery, AL 36106
Phone (334) 293-8888

2060 Berryhill Rd
Montgomery, AL 36117
Phone (334) 416-8996

1722 Pine St
Ste 503
Montgomery, AL 36106
Phone (334) 240-2337

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hayneville Family Health CenterHayneville, AL, CCN 011979 Federally qualified health center Corporate Director Apr 28, 2020
Autaugaville Family Health CenterAutaugaville, AL, CCN 011982 Federally qualified health center Corporate Director Apr 28, 2020
Clanton Family Health CenterClanton, AL, CCN 011977 Federally qualified health center Corporate Director Apr 28, 2020
Chisholm Family Health CenterMontgomery, AL, CCN 011981 Federally qualified health center Corporate Director Apr 28, 2020
Gateway Family Health CenterMontgomery, AL, CCN 011806 Federally qualified health center Corporate Director Apr 28, 2020
Montgomery East Family Health CenterMontgomery, AL, CCN 011008 Federally qualified health center Corporate Director Apr 28, 2020
Living Well Specialty ClinicMontgomery, AL, CCN 011127 Federally qualified health center Corporate Director Apr 10, 2025

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1114244456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241587",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361241587",
            "telephone_number": "334-280-1500",
            "fax_number": "334-280-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 BERRYHILL RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173599",
            "telephone_number": "334-676-3366",
            "fax_number": "334-676-3367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "273 Winton M Blount Loop",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361173507",
            "country_code": "US",
            "telephone_number": "334-280-1500",
            "fax_number": "334-280-1600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1758 Park Pl Ste 402",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361061135",
            "country_code": "US",
            "telephone_number": "334-293-6842",
            "fax_number": "334-293-6843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUFORD-GUICE",
        "first_name": "JURWARDOLYN",
        "middle_name": "ADAIRA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-096626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.