Individual provider Active NPI

Olivia Smith Carruth, CRNP

  • Neonatal Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1194580183
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
1-166689 Issued in AL
Practice address
2010 Brookwood Medical Ctr Dr
Birmingham, AL 35209-6804
Phone
(205) 547-4400
NPI assigned
Feb 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 1-166689 AL Primary

Addresses

Primary practice location

2010 Brookwood Medical Ctr Dr
Birmingham, AL 35209-6804

Mailing address

8752 Lodge LN
Cottondale, AL 35453-1306
Phone (205) 295-8384

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
1-166689ALMDNeonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1194580183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8752 LODGE LN",
            "city": "COTTONDALE",
            "state": "AL",
            "postal_code": "354531306",
            "telephone_number": "205-295-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BROOKWOOD MEDICAL CTR DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096804",
            "telephone_number": "205-547-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRUTH",
        "first_name": "OLIVIA",
        "middle_name": "SMITH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AL",
            "license": "1-166689",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 19, 2024; 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.