NPI Code Detail JSON Logo

1730050014 NPI number — MR. MICHAEL JEROME STURDIVANT

NPI Number: 1730050014
Health Care Provider/Practitioner: MR. MICHAEL JEROME STURDIVANT

Information about “1730050014” NPI (MR. MICHAEL JEROME STURDIVANT) exists in 1730050014 in HTML format HTML  |  1730050014 in plain Text format TXT  |  1730050014 in PDF (Portable Document Format) PDF  |  1730050014 in an XML format XML  formats.

NPI Number : 1730050014 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730050014",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STURDIVANT",
    "FirstName": "MICHAEL",
    "MiddleName": "JEROME",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4100 MARKET ST STE 100",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HUNTSVILLE",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35808-3007",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "256-203-3883",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3311 BOB WALLACE AVE SW STE 205",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HUNTSVILLE",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35805-4064",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "256-690-3943",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/17/2025",
    "LastUpdateDate": "10/24/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TP2701X",
          "TaxonomyName": "Group Psychotherapy Psychologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106H00000X",
          "TaxonomyName": "Marriage & Family Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "133N00000X",
          "TaxonomyName": "Nutritionist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "133VN1201X",
          "TaxonomyName": "Obesity and Weight Management Nutrition Registered Dietitian",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171400000X",
          "TaxonomyName": "Health & Wellness Coach",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "173C00000X",
          "TaxonomyName": "Reflexologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "174200000X",
          "TaxonomyName": "Meals Provider",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "174H00000X",
          "TaxonomyName": "Health Educator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "175L00000X",
          "TaxonomyName": "Homeopath",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QI0500X",
          "TaxonomyName": "Infusion Therapy Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320800000X",
          "TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "175F00000X",
          "TaxonomyName": "Naturopath",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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