Individual provider Active NPI

Beverly Jane Parker, CRNP

  • Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1437110061
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1036230 Issued in AL
Practice address
251 N Bayou St
Mobile, AL 36603-5827
Phone
(251) 690-8158
Fax
(251) 544-2188
NPI assigned
Mar 31, 2006
Last updated
Jun 23, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1036230 AL Primary

Addresses

Primary practice location

251 N Bayou St
Mobile, AL 36603-5827

Mailing address

PO Box 2867
Mobile, AL 36652-2867
Phone (251) 690-8158

Other identifiers 3

IdentifierTypeStateIssuer
1063439065OtherALSITE GROUP PAYEE NUMBER
630000013MedicaidAL
011846OtherALMEDICARE GROUP PAYEE NUMBER

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
1036230ALMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1437110061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2867",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366522867",
            "telephone_number": "251-690-8158",
            "fax_number": "251-544-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 N BAYOU ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035827",
            "telephone_number": "251-690-8158",
            "fax_number": "251-544-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BEVERLY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1036230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE GROUP PAYEE NUMBER",
            "identifier": "1063439065",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000013",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PAYEE NUMBER",
            "identifier": "011846",
            "state": "AL"
        }
    ],
    "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 Jun 23, 2009; 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.