NPIMap

Organization Active NPI

Pediatric Neuromotor Clinic

  • Pediatric Occupational Therapist
  • Birmingham, AL
National Provider Identifier
1790022762
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
PEDIATRIC NEUROMOTOR CLINIC
Practice address
933 19TH St S
Room 115
Birmingham, AL 35205-3703
Phone
(205) 975-0466
Fax
(205) 975-2380
NPI assigned
Jan 11, 2013
Last updated
Jan 11, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARKS CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Authorized official

Name
Mary Rebekah Trucks, M.S., OTR/L
Title
Director
Phone
(205) 975-0466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X NU Primary

Addresses

Primary practice location

933 19TH St S
Room 115
Birmingham, AL 35205-3703

Mailing address

1720 2ND Ave S
CH 19 307
Birmingham, AL 35294-2041
Phone (205) 975-0466

National Provider Directory

National Provider Directory
Tax ID family
Robert T Brown MD48 organizations share this tax ID, including this one
Part of
Robert T Brown MD

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

1720 2nd Ave S
#19
Birmingham, AL 35294

933 19th St S
Rm 115
Birmingham, AL 35205
Phone (205) 975-0466

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1790022762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 2ND AVE S",
            "address_2": "CH 19 307",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352942041",
            "telephone_number": "205-975-0466",
            "fax_number": "205-975-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 19TH ST S",
            "address_2": "ROOM 115",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053703",
            "telephone_number": "205-975-0466",
            "fax_number": "205-975-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NEUROMOTOR CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARKS CLINIC",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "TRUCKS",
        "authorized_official_first_name": "MARY REBEKAH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "205-975-0466",
        "authorized_official_credential": "M.S., OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "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 Jan 11, 2013; 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.