Active NPI
Mirriam Rugurue Ford
- Clinical Psychologist
- Anniston, AL
National Provider Identifier
1235828518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810008082
- Practice address
- 300 Sky Dr
Anniston, AL 36207-6360 - Phone
- (219) 614-9456
- NPI assigned
- May 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810008082 | VA | Primary |
Addresses
Primary practice location
300 Sky Dr
Anniston, AL 36207-6360
Mailing address
300 Sky Dr
Anniston, AL 36207-6360
Phone (219) 614-9456
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | betterhelp.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 0810008082 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683072000000",
"number": "1235828518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SKY DR",
"city": "ANNISTON",
"state": "AL",
"postal_code": "362076360",
"telephone_number": "219-614-9456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SKY DR",
"city": "ANNISTON",
"state": "AL",
"postal_code": "362076360",
"telephone_number": "219-614-9456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "MIRRIAM",
"middle_name": "RUGURUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-03",
"last_updated": "2023-05-03",
"certification_date": "2023-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810008082",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "betterhelp.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Client Notes",
"address_1": "300 Sky Dr",
"city": "Anniston",
"state": "AL",
"country_code": "US",
"postal_code": "362076360",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Anniston, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.