Individual provider Active NPI

Barberous Benderson, CRNP

  • General Practice Registered Nurse
  • Tuscaloosa, AL
National Provider Identifier
1114304482
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
1-020482 Issued in AL
Practice address
200 University Blvd
Tuscaloosa, AL 35401-1250
Phone
(205) 759-0900
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 1-020482 AL Primary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 1-020482 AL

Addresses

Primary practice location

200 University Blvd
Tuscaloosa, AL 35401-1250

Mailing address

200 University Blvd
Tuscaloosa, AL 35401-1250
Phone (205) 759-0900

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

LicenseStateTypeSpecialty
1-020482ALMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1114304482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354011250",
            "telephone_number": "205-759-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354011250",
            "telephone_number": "205-759-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDERSON",
        "first_name": "BARBEROUS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "AL",
            "license": "1-020482",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "AL",
            "license": "1-020482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.