Active NPI
Sandra C. Redden, DR.
- Clinical Child & Adolescent Psychologist
- Birmingham, AL
National Provider Identifier
1932202173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 1147
- Practice address
- 15 Office Park Circle
Suite 140
Birmingham, AL 35223 - Phone
- (205) 523-8219
- Fax
- (205) 523-8219
- NPI assigned
- Sep 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 1147 | AL | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1147 | AL | Primary |
Addresses
Primary practice location
15 Office Park Circle
Suite 140
Birmingham, AL 35223
Mailing address
15 Office Park Circle
Suite 104
Birmingham, AL 35223
Phone (205) 523-8219
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 515-28851 | Other | AL | BCBS OF AL PROVIDER # |
| 139124 | Medicaid | AL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1147 | AL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456704000000",
"number": "1932202173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 OFFICE PARK CIRCLE",
"address_2": "SUITE 104",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35223",
"telephone_number": "205-523-8219",
"fax_number": "205-523-8219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 OFFICE PARK CIRCLE",
"address_2": "SUITE 140",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35223",
"telephone_number": "205-523-8219",
"fax_number": "205-523-8219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDEN",
"first_name": "SANDRA",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "DR.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2016-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "AL",
"license": "1147",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "AL",
"license": "1147",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL PROVIDER #",
"identifier": "515-28851",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139124",
"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 Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.