Individual provider Active NPI

Tia La'Shey Sturdivant, CRNP

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1245054733
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-149855 Issued in AL
Practice address
1725 Pine St
Montgomery, AL 36106-1117
Phone
(334) 293-8000
NPI assigned
Nov 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-149855 AL Primary

Addresses

Primary practice location

1725 Pine St
Montgomery, AL 36106-1117

Mailing address

403 County Road 819
Selma, AL 36701-1901

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251018000196 AL Practitioner - Nurse Practitioner 9830687268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Urgent Care LLCGroup PAC ID 8820305600, 171 clinicians

Practice addresses (Care Compare)

3039 Vaughn Rd
Montgomery, AL 36106-2731
Phone (334) 513-7819

3116 Parliament Cir
Montgomery, AL 36116-7271
Phone (334) 651-8685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-149855ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Urgent Care LLC CurrentSince Sep 7, 2025 Accepting new patients
Rural Urgent Care LLC CurrentSince Sep 7, 2025 Accepting new patients

Locations

1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1245054733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 COUNTY ROAD 819",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367011901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PINE ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061117",
            "telephone_number": "334-293-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDIVANT",
        "first_name": "TIA",
        "middle_name": "LA'SHEY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-149855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.