Active NPI
Andrew Jackson Myrick Jr., M.D.
- Family Medicine Physician
- Birmingham, AL
National Provider Identifier
1689734550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 13729
- Practice address
- 1 W Lakeshore Dr Ste 100
Birmingham, AL 35209-7271 - Phone
- (205) 930-2950
- Fax
- (205) 930-2957
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 13729 | AL | Primary |
Addresses
Primary practice location
1 W Lakeshore Dr Ste 100
Birmingham, AL 35209-7271
Mailing address
1 W Lakeshore Dr Ste 100
Birmingham, AL 35209-7271
Phone (205) 930-2950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051039775 | Other | AL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13729 | AL | MD | Family Medicine Physician |
| 13729 | TN | MD | Certified Registered Nurse Anesthetist |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689734550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 W LAKESHORE DR STE 100",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352097271",
"telephone_number": "205-930-2950",
"fax_number": "205-930-2957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 W LAKESHORE DR STE 100",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352097271",
"telephone_number": "205-930-2950",
"fax_number": "205-930-2957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYRICK",
"first_name": "ANDREW",
"middle_name": "JACKSON",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "13729",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "051039775",
"state": "AL"
}
],
"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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.