Active NPI
Paul D Blanton
- Clinical Neuropsychologist
- Birmingham, AL
National Provider Identifier
1194738864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 1145
- Practice address
- 619 19TH Street South
Birmingham, AL 35233 - Phone
- (205) 934-6600
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1145 | AL | |
| Clinical Neuropsychologist | 103G00000X | 1145 | AL | Primary |
Addresses
Primary practice location
619 19TH Street South
Birmingham, AL 35233
Mailing address
P O Box 55310
Birmingham, AL 35255-5310
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1145 | AL | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196985600000",
"number": "1194738864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 55310",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352555310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 19TH STREET SOUTH",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35233",
"telephone_number": "205-934-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANTON",
"first_name": "PAUL",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1145",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "AL",
"license": "1145",
"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 Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.