Lacey Shuttleworth, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-165062 Issued in AL

Practice address

1802 6TH Ave S
Birmingham, AL 35233-1932

Phone

(205) 934-3411

NPI assigned

May 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AL

  Medicare reassignment NPD
• Corelife Inc

  • Family Medicine Physician
  • Hoover, AL
  • NPI 1073003745
  NPD (past)

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1609499722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 17TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352056608",
            "telephone_number": "941-779-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331932",
            "telephone_number": "205-934-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTTLEWORTH",
        "first_name": "LACEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-165062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chablis Lee Shultz, MSN, CRNP
• Luke Austin Ross Shumaker, MD
• Charles Raymond Shumate, MD
• Elizabeth Ann Shumway, MD
• Hayden Douglas Shuster, MD, PHARMD
• Gerold Noel Sibanda, MD
• Michael Joseph Sibel, D.O.
• Kristi Sibert, MA, RD, LD, CEDRD
• David H Sibley, MD
• Angela Danielle Sickels, MD

• Family Nurse Practitioner in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.