Individual provider Active NPI

Cheryl Millsaps Azrin, PH. D.

  • Clinical Neuropsychologist
  • Birmingham, AL
National Provider Identifier
1205917788
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
831 Issued in AL
Practice address
4260 Cahaba Heights CT
Ste 180
Birmingham, AL 35243-5711
Phone
(205) 329-7815
Fax
(205) 329-7816
NPI assigned
Oct 18, 2006
Last updated
May 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X AL831 AL
Clinical Neuropsychologist 103G00000X 831 AL Primary
Clinical Psychologist 103TC0700X AL831 AL
Clinical Psychologist 103TC0700X 831 AL

Addresses

Primary practice location

4260 Cahaba Heights CT
Ste 180
Birmingham, AL 35243-5711

Mailing address

4260 Cahaba Heights CT
Ste 180
Birmingham, AL 35243-5711
Phone (205) 329-7815

Other identifiers 1

IdentifierTypeStateIssuer
051501127OtherALBLUE CROSS OF ALABAMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111213000689 AL Practitioner - Clinical Psychologist 1153596515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Birmingham NeuropsychologyGroup PAC ID 1153340351, 2 clinicians

Practice addresses (Care Compare)

4260 Cahaba Heights CT
Suite 180
Vestavia, AL 35243-5711
Phone (205) 329-7815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
AL831ALMDClinical Psychologist
831ALMDOther Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Birmingham Neuropsychology Clinical Neuropsychologist CurrentSince Apr 16, 2001 Accepting new patients
Dr Frank a Brotherton LLC Clinical PastSince Apr 16, 2001 Accepting new patients

Locations

2018 Brookwood Medical Ctr Dr
Ste 310
Birmingham, AL 35209
Phone (205) 329-7815

4260 Cahaba Heights Ct
Ste 180
Vestavia, AL 35243
Phone (205) 329-7815

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1205917788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 CAHABA HEIGHTS CT",
            "address_2": "STE 180",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352435711",
            "telephone_number": "205-329-7815",
            "fax_number": "205-329-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 CAHABA HEIGHTS CT",
            "address_2": "STE 180",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352435711",
            "telephone_number": "205-329-7815",
            "fax_number": "205-329-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZRIN",
        "first_name": "CHERYL",
        "middle_name": "MILLSAPS",
        "credential": "PH. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AL",
            "license": "AL831",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AL",
            "license": "831",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "AL831",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "831",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ALABAMA",
            "identifier": "051501127",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.