Individual provider Active NPI

Vickie Sturdivant, CRNP

  • Adult Health Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1629091657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1-046300 Issued in AL
Practice address
700 19TH St S
Administrative Medicine (11F)
Birmingham, AL 35233-1927
Phone
(205) 933-8101
Fax
(205) 558-4809
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-046300 AL Primary

Addresses

Primary practice location

700 19TH St S
Administrative Medicine (11F)
Birmingham, AL 35233-1927

Mailing address

700 19TH St S
Administrative Medicine (11F)
Birmingham, AL 35233-1927
Phone (205) 933-8101

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
1-046300ALMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629091657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 19TH ST S",
            "address_2": "ADMINISTRATIVE MEDICINE (11F)",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331927",
            "telephone_number": "205-933-8101",
            "fax_number": "205-558-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 19TH ST S",
            "address_2": "ADMINISTRATIVE MEDICINE (11F)",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331927",
            "telephone_number": "205-933-8101",
            "fax_number": "205-558-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDIVANT",
        "first_name": "VICKIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-046300",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.