Active NPI
Debra Jordan Patterson, PHD
- Clinical Psychologist
- Birmingham, AL
National Provider Identifier
1871667998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 771
- Practice address
- 813 Shades Creek Pkwy
Suite 202a
Birmingham, AL 35209-4542 - Phone
- (205) 870-5678
- NPI assigned
- Nov 20, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 771 | AL | Primary |
| Psychologist | 103T00000X | 771 | AL |
Addresses
Primary practice location
813 Shades Creek Pkwy
Suite 202a
Birmingham, AL 35209-4542
Mailing address
813 Shades Creek Pkwy
Suite 202a
Birmingham, AL 35209-4542
Phone (205) 870-5678
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 510-74851 | Other | AL | BCBS |
| 000074851 | Medicaid | AL | |
| 510-74849 | Other | AL | BCBS |
| 000074849 | Medicaid | AL | |
| 1871667998 | Other | AL | TRICARE SOUTH |
| 515-02328 | Other | AL | FEDERAL BC |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 771 | AL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273622400000",
"number": "1871667998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 SHADES CREEK PKWY",
"address_2": "SUITE 202A",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352094542",
"telephone_number": "205-870-5678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 SHADES CREEK PKWY",
"address_2": "SUITE 202A",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352094542",
"telephone_number": "205-870-5678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "DEBRA",
"middle_name": "JORDAN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2010-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "771",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AL",
"license": "771",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "510-74851",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000074851",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "510-74849",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000074849",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE SOUTH",
"identifier": "1871667998",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BC",
"identifier": "515-02328",
"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 May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.