Individual provider Active NPI

Shauna Berg

  • Phlebotomy Technician
  • Mobile, AL
National Provider Identifier
1376998740
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
K4H9M4J4 Issued in AL
Practice address
1903 Spring Hill Ave
Mobile, AL 36607-2303
Phone
(251) 295-5110
Fax
(251) 545-4963
NPI assigned
May 4, 2016
Last updated
May 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X K4H9M4J4 AL Primary

Addresses

Primary practice location

1903 Spring Hill Ave
Mobile, AL 36607-2303

Mailing address

1903 Spring Hill Ave
Mobile, AL 36607-2303
Phone (251) 295-5110

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

LicenseStateTypeSpecialty
K4H9M4J4ALMDPhlebotomy Technician

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1376998740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072303",
            "telephone_number": "251-295-5110",
            "fax_number": "251-545-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072303",
            "telephone_number": "251-295-5110",
            "fax_number": "251-545-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "SHAUNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "AL",
            "license": "K4H9M4J4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.