NPI Code Detail JSON Logo

1679885925 NPI number — BEVERLY JEAN MYERS MA, PHD, AHNP-C

NPI Number: 1679885925
Health Care Provider/Practitioner: BEVERLY JEAN MYERS MA, PHD, AHNP-C

Information about “1679885925” NPI (BEVERLY JEAN MYERS MA, PHD, AHNP-C) exists in 1679885925 in HTML format HTML  |  1679885925 in plain Text format TXT  |  1679885925 in PDF (Portable Document Format) PDF  |  1679885925 in an XML format XML  formats.

NPI Number : 1679885925 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679885925",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MYERS",
    "FirstName": "BEVERLY",
    "MiddleName": "JEAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MA, PHD, AHNP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HULSEY",
    "OtherFirstName": "BEVERLY",
    "OtherMiddleName": "JEAN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "NCC, ALC",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "2909 HIGHLAND AVE S",
    "SecondLineMailingAddress": "SHERATON APARTMENTS # 501",
    "MailingAddressCityName": "BIRMINGHAM",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35205-1932",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "205-903-1482",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2909 HIGHLAND AVE S",
    "SecondLinePracticeLocationAddress": "SHERATON APARTMENTS # 501",
    "PracticeLocationAddressCityName": "BIRMINGHAM",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35205-1932",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "205-903-1482",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/01/2010",
    "LastUpdateDate": "06/26/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "06/27/2018",
    "NPIReactivationDate": "06/19/2019",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "3088",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "3088",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "3088",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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