Active NPI
Tammi Black, LPN
- Professional Counselor
- Huntsville, AL
National Provider Identifier
1609244235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4002
- Practice address
- 4040 Memorial Pkwy SW
Huntsville, AL 35802-4364 - Phone
- (256) 533-1970
- Fax
- (256) 705-6477
- NPI assigned
- Sep 14, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 2-055887 | AL | |
| Professional Counselor | 101YP2500X | 4002 | AL | Primary |
Addresses
Primary practice location
4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Mailing address
4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Phone (256) 533-1970
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 330000014 | Medicaid | AL |
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 |
|---|---|---|---|
| 4002 | AL | MD | Professional Counselor |
| 2-055887 | AL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553644800000",
"number": "1609244235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4040 MEMORIAL PKWY SW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358024364",
"telephone_number": "256-533-1970",
"fax_number": "256-705-6477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4040 MEMORIAL PKWY SW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358024364",
"telephone_number": "256-533-1970",
"fax_number": "256-705-6477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "TAMMI",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-14",
"last_updated": "2019-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AL",
"license": "2-055887",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "4002",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "330000014",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.