Individual provider Active NPI

Joseph Lee Stork Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Tuscaloosa, AL
National Provider Identifier
1114383593
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-119062 Issued in AL
Practice address
809 University Blvd E
Tuscaloosa, AL 35401-2029
Phone
(205) 759-7111
NPI assigned
Jan 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-119062 AL Primary

Addresses

Primary practice location

809 University Blvd E
Tuscaloosa, AL 35401-2029

Mailing address

809 University Blvd E
Tuscaloosa, AL 35401-2029
Phone (205) 759-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160222002006 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719282243 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiologists Associated PCGroup PAC ID 6204739519, 418 clinicians

Practice addresses (Care Compare)

3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone (205) 848-2925

Hospital & facility affiliations

  • Grandview Medical Center Hospital, Birmingham, AL, CCN 010104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists Associated PC CurrentSince Jun 8, 2020 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered CurrentSince Jun 8, 2020 Accepting new patients
DCH Medical Center Crna Nurse Anesthetist, Certified Registered CurrentSince Jan 13, 2016 Accepting new patients

Locations

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1114383593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012029",
            "telephone_number": "205-759-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012029",
            "telephone_number": "205-759-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORK",
        "first_name": "JOSEPH",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-119062",
            "primary": true
        }
    ],
    "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 Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.