Active NPI
Julene Ranicea Pearson, M.D.
- Family Medicine Physician
- Birmingham, AL
National Provider Identifier
1366414708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 00017145
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G592 | Other | AL | MEDICARE GROUP NUMBER |
| 051032285 | Other | AL | BLUE SHIELD OF AL. |
| 303790344 | Medicaid | AL | |
| 1396770913 | Other | AL | GROUP 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
| License | State | Type | Specialty |
|---|---|---|---|
| 00017145 | AL | MD | Family 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.