Active NPI
Michelle Burleson
- Pharmacist
- Moulton, AL
National Provider Identifier
1356816995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20633
- Practice address
- 15445 Al Highway 24
Moulton, AL 35650-6602 - Phone
- (256) 974-1597
- NPI assigned
- Oct 10, 2018
- Last updated
- Oct 10, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20633 | AL | Primary |
Addresses
Primary practice location
15445 Al Highway 24
Moulton, AL 35650-6602
Mailing address
2454 County Road 1162
Cullman, AL 35057-0641
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 |
|---|---|---|---|
| 20633 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539129600000",
"number": "1356816995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2454 COUNTY ROAD 1162",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350570641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15445 AL HIGHWAY 24",
"city": "MOULTON",
"state": "AL",
"postal_code": "356506602",
"telephone_number": "256-974-1597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURLESON",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-10",
"last_updated": "2018-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "20633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moulton, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.