Individual provider Active NPI

Julene Ranicea Pearson, M.D.

  • Family Medicine Physician
  • Birmingham, AL
National Provider Identifier
1366414708
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00017145 Issued in AL
Practice address
1308 Tuscaloosa Ave SW
Birmingham, AL 35211-1948
Phone
(205) 715-6121
Fax
(205) 715-6183
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 00017145 AL Primary

Addresses

Primary practice location

1308 Tuscaloosa Ave SW
Birmingham, AL 35211-1948

Mailing address

1308 Tuscaloosa Ave SW
Birmingham, AL 35211-1948
Phone (205) 715-6121

Other identifiers 4

IdentifierTypeStateIssuer
G592OtherALMEDICARE GROUP NUMBER
051032285OtherALBLUE SHIELD OF AL.
303790344MedicaidAL
1396770913OtherALGROUP PAYEE NPI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00017145ALMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1366414708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 TUSCALOOSA AVE SW",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111948",
            "telephone_number": "205-715-6121",
            "fax_number": "205-715-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 TUSCALOOSA AVE SW",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111948",
            "telephone_number": "205-715-6121",
            "fax_number": "205-715-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "JULENE",
        "middle_name": "RANICEA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00017145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "G592",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF AL.",
            "identifier": "051032285",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303790344",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PAYEE NPI",
            "identifier": "1396770913",
            "state": "AL"
        }
    ],
    "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 Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.