Active NPI
Allen Edgar Shealy, PHD
- Psychologist
- Birmingham, AL
National Provider Identifier
1891887188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- AL#100
- Practice address
- 1613 21St St So
Birmingham, AL 35205-4952 - Phone
- (205) 933-7849
- Fax
- (205) 933-7880
- NPI assigned
- Sep 28, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | AL#100 | AL | Primary |
Addresses
Primary practice location
1613 21St St So
Birmingham, AL 35205-4952
Mailing address
1613 21St St So
Birmingham, AL 35205-4952
Phone (205) 933-7849
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL#100 | AL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306195200000",
"number": "1891887188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1613 21ST ST SO",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352054952",
"telephone_number": "205-933-7849",
"fax_number": "205-933-7880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1613 21ST ST SO",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352054952",
"telephone_number": "205-933-7849",
"fax_number": "205-933-7880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEALY",
"first_name": "ALLEN",
"middle_name": "EDGAR",
"name_prefix": "Mr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2011-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AL",
"license": "AL#100",
"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 May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.