Others titles
- Full Replacement Monthly NPI File
- NPPES Data Dissemination
- NPI Data Analytics for Individual/Organization
- NPI Data Analytics for Sole Proprietor/Subpart
- NPI Data Analytics for male/female
- NPI Data Analytics for US States
- NPI Data Analytics for Countries
- NPI Data Analytics for Taxonomy Codes
Keywords
- National Provider Identifier Standard (NPI)
- NPPES
- Health care providers
- Regulation & Guidance
- Data Dissemination
- NPI Number
- NPI Registry
- National Provider Identifier
Healthcare Providers National Provider Identifier Data
This dataset contains the Health Care Providers data. Each line in the dataset represents an NPI record.
The NPI is a unique identification number for covered health care providers.
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Description
In September 2007, CMS began disclosing National Plan and Provider Enumeration System (NPPES) health care provider data that are disclosable under the Freedom of Information Act (FOIA) to the public. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.
This dataset will contain all of the FOIA-disclosable provider data in NPPES. It contains the fields identified in the NPPES Data Dissemination Notice and certain sub-fields related to those fields will be disclosed in the data set.
Note: CMS will mask SSNs, IRS ITINs, and EINs when these numbers are entered in the Other Provider Identifier Number and License Number fields as . This action also includes the continued suppression of the EINs and the suppression of the Subpart Parent Organization TINs of all Organizations in the downloadable file. CMS expects to lift the suppression of EINs and Parent Organization TINs in the future.
About this Dataset
Data Info
Date Created | 2007-09 |
---|---|
Last Modified | 2023-07-10 |
Version | 2023-07-13 |
Update Frequency |
Monthly |
Temporal Coverage |
2005-05 to 2023-07 |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicare and Medicaid Services (CMS); |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | National Provider Identifier Standard (NPI), NPPES, Health care providers, Regulation & Guidance, Data Dissemination, NPI Number, NPI Registry, National Provider Identifier |
Other Titles | Full Replacement Monthly NPI File, NPPES Data Dissemination, NPI Data Analytics for Individual/Organization, NPI Data Analytics for Sole Proprietor/Subpart, NPI Data Analytics for male/female, NPI Data Analytics for US States, NPI Data Analytics for Countries, NPI Data Analytics for Taxonomy Codes |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
NPI | The NPI is a 10-digit unique identification number for covered health care providers. | integer | level : Nominalrequired : 1unique : 1pattern : d{10} |
Entity_Type | Individual or Organization | string | enum : Array ( [0] => Individual [1] => Organization ) |
Replacement_NPI | The NPI is a 10-digit unique identification number for covered health care providers. | integer | level : Nominalpattern : d{10} |
Employer_Identification_Number | Employer Identification number. The value is not disclosed by CMS | string | - |
Provider_Organization_Name | Legal Business Name | string | maxLength : 70 |
Provider_Last_Name | Legal Name | string | maxLength : 35 |
Provider_First_Name | First Name | string | maxLength : 20 |
Provider_Middle_Name | Middle Name | string | maxLength : 20 |
Provider_Name_Prefix_Code | Name Prefix codes | string | maxLength : 5 |
Provider_Name_Suffix_Code | Name Suffix codes | string | maxLength : 5 |
Provider_Credential_Text | Provider Credential Text | string | maxLength : 20 |
Provider_Other_Organization_Name | Organization Name | string | maxLength : 70 |
Provider_Other_Organization_Name_Type_Description | Provider Other Organization Name Type Description | string | - |
Provider_Other_Last_Name | Legal Name | string | maxLength : 35 |
Provider_Other_First_Name | First Name | string | maxLength : 20 |
Provider_Other_Middle_Name | Middle Name | string | maxLength : 20 |
Provider_Other_Name_Prefix_Code | Name Prefix codes | string | maxLength : 5 |
Provider_Other_Name_Suffix_Code | Name Suffix codes | string | maxLength : 5 |
Provider_Other_Credential_Text | Provider Credential Text | string | maxLength : 20 |
Provider_Other_Last_Name_Type_Description | Provider Other Last Name Type Description | string | - |
Provider_Business_Mailing_Address_First_Line | First line business address | string | maxLength : 55 |
Provider_Business_Mailing_Address_Second_Line | Second line business address | string | maxLength : 55 |
Provider_Business_Mailing_Address_City_Name | City name | string | maxLength : 40 |
Provider_Business_Mailing_Address_State_Name | US State Code | string | maxLength : 100 |
Provider_Business_Mailing_Address_Postal_Code | Zip Code | string | maxLength : 20 |
Provider_Business_Mailing_Address_Country_Code | Enrich: GeoCode | string | maxLength : 2 |
Provider_Business_Mailing_Address_Telephone_Number | Telephone number | string | maxLength : 20 |
Provider_Business_Mailing_Address_Fax_Number | Fax number | string | maxLength : 20 |
Provider_Business_Practice_Location_Address_First_Line | First line business address | string | maxLength : 55 |
Provider_Business_Practice_Location_Address_Second_Line | Second line business address | string | maxLength : 55 |
Provider_Business_Practice_Location_Address_City_Name | City name | string | maxLength : 40 |
Provider_Business_Practice_Location_Address_State_Name | US State Code | string | maxLength : 100 |
Provider_Business_Practice_Location_Address_Postal_Code | Zip Code | string | maxLength : 20 |
Provider_Business_Practice_Location_Address_Country_Code | Country Code | string | maxLength : 2 |
Provider_Business_Practice_Location_Address_Telephone_Number | Telephone number | string | maxLength : 20 |
Provider_Business_Practice_Location_Address_Fax_Number | Fax number | string | maxLength : 20 |
Provider_Enumeration_Date | Enumeration date | date | - |
Last_Update_Date | Update date | date | - |
NPI_Deactivation_Reason | Reasons for deactivation | string | enum : Array ( [0] => Death [1] => Disbandment [2] => Fraud [3] => Other ) maxLength : 20 |
NPI_Deactivation_Date | NPI Deactivation date | date | - |
NPI_Reactivation_Date | NPI Reactivation date | date | - |
Provider_Gender_Code | Gender code | string | enum : Array ( [0] => Male [1] => Female ) maxLength : 20 |
Authorized_Official_Last_Name | Legal Name | string | maxLength : 35 |
Authorized_Official_First_Name | First Name | string | maxLength : 20 |
Authorized_Official_Middle_Name | Middle Name | string | maxLength : 20 |
Authorized_Official_Title_or_Position | Title | string | maxLength : 35 |
Authorized_Official_Telephone_Number | Telephone Number | string | maxLength : 20 |
Healthcare_Provider_Taxonomy_Code_1 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_1 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_1 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_1 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_2 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_2 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_2 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_2 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_3 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_3 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_3 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_3 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_4 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_4 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_4 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_4 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_5 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_5 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_5 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_5 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_6 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_6 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_6 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_6 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_7 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_7 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_7 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_7 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_8 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_8 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_8 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_8 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_9 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_9 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_9 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_9 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_10 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_10 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_10 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_10 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_11 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_11 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_11 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_11 | true-The taxonomy is the primary taxonomy (there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_12 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_12 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_12 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_12 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_13 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_13 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_13 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_13 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_14 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_14 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_14 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_14 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Healthcare_Provider_Taxonomy_Code_15 | Health Care Provider Taxonomy Code | string | maxLength : 10 |
Provider_License_Number_15 | License Number | string | maxLength : 20 |
Provider_License_Number_State_Code_15 | US State Code | string | maxLength : 2 |
Is_Healthcare_Provider_Primary_Taxonomy_15 | true-The taxonomy is the primary taxonomy(there can be only one per NPI record),false-The taxonomy is not the primary taxonomy, null–Not answered | boolean | - |
Other_Provider_Identifier_1 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_1 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_1 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_1 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_2 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_2 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_2 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_2 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_3 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_3 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_3 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_3 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_4 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_4 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_4 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_4 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_5 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_5 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_5 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_5 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_6 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_6 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_6 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_6 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_7 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_7 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_7 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_7 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_8 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_8 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_8 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_8 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_9 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_9 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_9 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_9 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_10 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_10 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_10 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_10 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_11 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_11 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_11 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_11 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_12 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_12 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_12 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_12 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_13 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_13 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_13 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_13 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_14 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_14 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_14 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_14 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_15 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_15 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_15 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_15 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_16 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_16 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_16 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_16 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_17 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_17 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_17 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_17 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_18 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_18 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_18 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_18 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_19 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_19 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_19 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_19 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_20 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_20 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_20 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_20 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_21 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_21 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_21 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_21 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_22 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_22 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_22 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_22 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_23 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_23 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_23 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_23 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_24 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_24 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_24 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_24 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_25 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_25 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_25 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_25 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_26 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_26 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_26 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_26 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_27 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_27 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_27 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_27 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_28 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_28 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_28 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_28 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_29 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_29 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_29 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_29 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_30 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_30 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_30 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_30 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_31 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_31 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_31 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_31 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_32 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_32 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_32 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_32 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_33 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_33 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_33 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_33 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_34 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_34 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_34 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_34 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_35 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_35 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_35 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_35 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_36 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_36 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_36 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_36 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_37 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_37 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_37 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_37 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_38 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_38 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_38 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_38 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_39 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_39 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_39 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_39 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_40 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_40 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_40 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_40 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_41 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_41 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_41 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_41 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_42 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_42 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_42 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_42 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_43 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_43 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_43 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_43 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_44 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_44 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_44 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_44 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_45 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_45 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_45 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_45 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_46 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_46 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_46 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_46 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_47 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_47 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_47 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_47 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_48 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_48 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_48 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_48 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_49 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_49 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_49 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_49 | Provider Identifier | string | maxLength : 80 |
Other_Provider_Identifier_50 | Other provider identifier | string | maxLength : 20 |
Other_Provider_Identifier_Type_Description_50 | The name of the health plan that issued the Other Provider Identifier | string | - |
Other_Provider_Identifier_State_Code_50 | US State Code | string | maxLength : 2 |
Other_Provider_Identifier_Issuer_50 | Provider Identifier | string | maxLength : 80 |
Is_Sole_Proprietor | A sole proprietor is not an incorporated individual because the sole proprietor did not form a corporation. If an HCP is a sole practitioner or solo practitioner, it does not necessarily mean he or she is a sole proprietor, and vice versa. | boolean | - |
Is_Organization_Subpart | An organization health care provider can get its subparts their own NPIs. If a subpart conducts any HIPAA standard | boolean | - |
Parent_Organization_LBN | Provider Organization Subpart Legal Business Name | string | maxLength : 70 |
Parent_Organization_TIN | Provider Organization Subpart TIN | string | maxLength : 9 |
Authorized_Official_Name_Prefix_Code | Name Prefix codes | string | maxLength : 5 |
Authorized_Official_Name_Suffix_Code | Name Suffix codes | string | maxLength : 5 |
Authorized_Official_Credential_Text | Provider Credential Text | string | maxLength : 20 |
Healthcare_Provider_Taxonomy_Group_Code_1 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_2 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_3 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_4 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_5 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_6 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_7 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_8 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_9 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_10 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_11 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_12 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_13 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_14 | Group Taxonomy Codes-Multi-Speciality Group,Single Speciality Group | string | maxLength : 70 |
Healthcare_Provider_Taxonomy_Group_Code_15 | Group Taxonomy Codes-Multi-Speciality Group, Single Speciality Group | string | maxLength : 70 |
Certification_Date | Indicates the date on which the provider certification completed | string | - |
Data Preview
NPI | Entity Type | Replacement NPI | Employer Identification Number | Provider Organization Name | Provider Last Name | Provider First Name | Provider Middle Name | Provider Name Prefix Code | Provider Name Suffix Code | Provider Credential Text | Provider Other Organization Name | Provider Other Organization Name Type Description | Provider Other Last Name | Provider Other First Name | Provider Other Middle Name | Provider Other Name Prefix Code | Provider Other Name Suffix Code | Provider Other Credential Text | Provider Other Last Name Type Description | Provider Business Mailing Address First Line | Provider Business Mailing Address Second Line | Provider Business Mailing Address City Name | Provider Business Mailing Address State Name | Provider Business Mailing Address Postal Code | Provider Business Mailing Address Country Code | Provider Business Mailing Address Telephone Number | Provider Business Mailing Address Fax Number | Provider Business Practice Location Address First Line | Provider Business Practice Location Address Second Line | Provider Business Practice Location Address City Name | Provider Business Practice Location Address State Name | Provider Business Practice Location Address Postal Code | Provider Business Practice Location Address Country Code | Provider Business Practice Location Address Telephone Number | Provider Business Practice Location Address Fax Number | Provider Enumeration Date | Last Update Date | NPI Deactivation Reason | NPI Deactivation Date | NPI Reactivation Date | Provider Gender Code | Authorized Official Last Name | Authorized Official First Name | Authorized Official Middle Name | Authorized Official Title or Position | Authorized Official Telephone Number | Healthcare Provider Taxonomy Code 1 | Provider License Number 1 | Provider License Number State Code 1 | Is Healthcare Provider Primary Taxonomy 1 | Healthcare Provider Taxonomy Code 2 | Provider License Number 2 | Provider License Number State Code 2 | Is Healthcare Provider Primary Taxonomy 2 | Healthcare Provider Taxonomy Code 3 | Provider License Number 3 | Provider License Number State Code 3 | Is Healthcare Provider Primary Taxonomy 3 | Healthcare Provider Taxonomy Code 4 | Provider License Number 4 | Provider License Number State Code 4 | Is Healthcare Provider Primary Taxonomy 4 | Healthcare Provider Taxonomy Code 5 | Provider License Number 5 | Provider License Number State Code 5 | Is Healthcare Provider Primary Taxonomy 5 | Healthcare Provider Taxonomy Code 6 | Provider License Number 6 | Provider License Number State Code 6 | Is Healthcare Provider Primary Taxonomy 6 | Healthcare Provider Taxonomy Code 7 | Provider License Number 7 | Provider License Number State Code 7 | Is Healthcare Provider Primary Taxonomy 7 | Healthcare Provider Taxonomy Code 8 | Provider License Number 8 | Provider License Number State Code 8 | Is Healthcare Provider Primary Taxonomy 8 | Healthcare Provider Taxonomy Code 9 | Provider License Number 9 | Provider License Number State Code 9 | Is Healthcare Provider Primary Taxonomy 9 | Healthcare Provider Taxonomy Code 10 | Provider License Number 10 | Provider License Number State Code 10 | Is Healthcare Provider Primary Taxonomy 10 | Healthcare Provider Taxonomy Code 11 | Provider License Number 11 | Provider License Number State Code 11 | Is Healthcare Provider Primary Taxonomy 11 | Healthcare Provider Taxonomy Code 12 | Provider License Number 12 | Provider License Number State Code 12 | Is Healthcare Provider Primary Taxonomy 12 | Healthcare Provider Taxonomy Code 13 | Provider License Number 13 | Provider License Number State Code 13 | Is Healthcare Provider Primary Taxonomy 13 | Healthcare Provider Taxonomy Code 14 | Provider License Number 14 | Provider License Number State Code 14 | Is Healthcare Provider Primary Taxonomy 14 | Healthcare Provider Taxonomy Code 15 | Provider License Number 15 | Provider License Number State Code 15 | Is Healthcare Provider Primary Taxonomy 15 | Other Provider Identifier 1 | Other Provider Identifier Type Description 1 | Other Provider Identifier State Code 1 | Other Provider Identifier Issuer 1 | Other Provider Identifier 2 | Other Provider Identifier Type Description 2 | Other Provider Identifier State Code 2 | Other Provider Identifier Issuer 2 | Other Provider Identifier 3 | Other Provider Identifier Type Description 3 | Other Provider Identifier State Code 3 | Other Provider Identifier Issuer 3 | Other Provider Identifier 4 | Other Provider Identifier Type Description 4 | Other Provider Identifier State Code 4 | Other Provider Identifier Issuer 4 | Other Provider Identifier 5 | Other Provider Identifier Type Description 5 | Other Provider Identifier State Code 5 | Other Provider Identifier Issuer 5 | Other Provider Identifier 6 | Other Provider Identifier Type Description 6 | Other Provider Identifier State Code 6 | Other Provider Identifier Issuer 6 | Other Provider Identifier 7 | Other Provider Identifier Type Description 7 | Other Provider Identifier State Code 7 | Other Provider Identifier Issuer 7 | Other Provider Identifier 8 | Other Provider Identifier Type Description 8 | Other Provider Identifier State Code 8 | Other Provider Identifier Issuer 8 | Other Provider Identifier 9 | Other Provider Identifier Type Description 9 | Other Provider Identifier State Code 9 | Other Provider Identifier Issuer 9 | Other Provider Identifier 10 | Other Provider Identifier Type Description 10 | Other Provider Identifier State Code 10 | Other Provider Identifier Issuer 10 | Other Provider Identifier 11 | Other Provider Identifier Type Description 11 | Other Provider Identifier State Code 11 | Other Provider Identifier Issuer 11 | Other Provider Identifier 12 | Other Provider Identifier Type Description 12 | Other Provider Identifier State Code 12 | Other Provider Identifier Issuer 12 | Other Provider Identifier 13 | Other Provider Identifier Type Description 13 | Other Provider Identifier State Code 13 | Other Provider Identifier Issuer 13 | Other Provider Identifier 14 | Other Provider Identifier Type Description 14 | Other Provider Identifier State Code 14 | Other Provider Identifier Issuer 14 | Other Provider Identifier 15 | Other Provider Identifier Type Description 15 | Other Provider Identifier State Code 15 | Other Provider Identifier Issuer 15 | Other Provider Identifier 16 | Other Provider Identifier Type Description 16 | Other Provider Identifier State Code 16 | Other Provider Identifier Issuer 16 | Other Provider Identifier 17 | Other Provider Identifier Type Description 17 | Other Provider Identifier State Code 17 | Other Provider Identifier Issuer 17 | Other Provider Identifier 18 | Other Provider Identifier Type Description 18 | Other Provider Identifier State Code 18 | Other Provider Identifier Issuer 18 | Other Provider Identifier 19 | Other Provider Identifier Type Description 19 | Other Provider Identifier State Code 19 | Other Provider Identifier Issuer 19 | Other Provider Identifier 20 | Other Provider Identifier Type Description 20 | Other Provider Identifier State Code 20 | Other Provider Identifier Issuer 20 | Other Provider Identifier 21 | Other Provider Identifier Type Description 21 | Other Provider Identifier State Code 21 | Other Provider Identifier Issuer 21 | Other Provider Identifier 22 | Other Provider Identifier Type Description 22 | Other Provider Identifier State Code 22 | Other Provider Identifier Issuer 22 | Other Provider Identifier 23 | Other Provider Identifier Type Description 23 | Other Provider Identifier State Code 23 | Other Provider Identifier Issuer 23 | Other Provider Identifier 24 | Other Provider Identifier Type Description 24 | Other Provider Identifier State Code 24 | Other Provider Identifier Issuer 24 | Other Provider Identifier 25 | Other Provider Identifier Type Description 25 | Other Provider Identifier State Code 25 | Other Provider Identifier Issuer 25 | Other Provider Identifier 26 | Other Provider Identifier Type Description 26 | Other Provider Identifier State Code 26 | Other Provider Identifier Issuer 26 | Other Provider Identifier 27 | Other Provider Identifier Type Description 27 | Other Provider Identifier State Code 27 | Other Provider Identifier Issuer 27 | Other Provider Identifier 28 | Other Provider Identifier Type Description 28 | Other Provider Identifier State Code 28 | Other Provider Identifier Issuer 28 | Other Provider Identifier 29 | Other Provider Identifier Type Description 29 | Other Provider Identifier State Code 29 | Other Provider Identifier Issuer 29 | Other Provider Identifier 30 | Other Provider Identifier Type Description 30 | Other Provider Identifier State Code 30 | Other Provider Identifier Issuer 30 | Other Provider Identifier 31 | Other Provider Identifier Type Description 31 | Other Provider Identifier State Code 31 | Other Provider Identifier Issuer 31 | Other Provider Identifier 32 | Other Provider Identifier Type Description 32 | Other Provider Identifier State Code 32 | Other Provider Identifier Issuer 32 | Other Provider Identifier 33 | Other Provider Identifier Type Description 33 | Other Provider Identifier State Code 33 | Other Provider Identifier Issuer 33 | Other Provider Identifier 34 | Other Provider Identifier Type Description 34 | Other Provider Identifier State Code 34 | Other Provider Identifier Issuer 34 | Other Provider Identifier 35 | Other Provider Identifier Type Description 35 | Other Provider Identifier State Code 35 | Other Provider Identifier Issuer 35 | Other Provider Identifier 36 | Other Provider Identifier Type Description 36 | Other Provider Identifier State Code 36 | Other Provider Identifier Issuer 36 | Other Provider Identifier 37 | Other Provider Identifier Type Description 37 | Other Provider Identifier State Code 37 | Other Provider Identifier Issuer 37 | Other Provider Identifier 38 | Other Provider Identifier Type Description 38 | Other Provider Identifier State Code 38 | Other Provider Identifier Issuer 38 | Other Provider Identifier 39 | Other Provider Identifier Type Description 39 | Other Provider Identifier State Code 39 | Other Provider Identifier Issuer 39 | Other Provider Identifier 40 | Other Provider Identifier Type Description 40 | Other Provider Identifier State Code 40 | Other Provider Identifier Issuer 40 | Other Provider Identifier 41 | Other Provider Identifier Type Description 41 | Other Provider Identifier State Code 41 | Other Provider Identifier Issuer 41 | Other Provider Identifier 42 | Other Provider Identifier Type Description 42 | Other Provider Identifier State Code 42 | Other Provider Identifier Issuer 42 | Other Provider Identifier 43 | Other Provider Identifier Type Description 43 | Other Provider Identifier State Code 43 | Other Provider Identifier Issuer 43 | Other Provider Identifier 44 | Other Provider Identifier Type Description 44 | Other Provider Identifier State Code 44 | Other Provider Identifier Issuer 44 | Other Provider Identifier 45 | Other Provider Identifier Type Description 45 | Other Provider Identifier State Code 45 | Other Provider Identifier Issuer 45 | Other Provider Identifier 46 | Other Provider Identifier Type Description 46 | Other Provider Identifier State Code 46 | Other Provider Identifier Issuer 46 | Other Provider Identifier 47 | Other Provider Identifier Type Description 47 | Other Provider Identifier State Code 47 | Other Provider Identifier Issuer 47 | Other Provider Identifier 48 | Other Provider Identifier Type Description 48 | Other Provider Identifier State Code 48 | Other Provider Identifier Issuer 48 | Other Provider Identifier 49 | Other Provider Identifier Type Description 49 | Other Provider Identifier State Code 49 | Other Provider Identifier Issuer 49 | Other Provider Identifier 50 | Other Provider Identifier Type Description 50 | Other Provider Identifier State Code 50 | Other Provider Identifier Issuer 50 | Is Sole Proprietor | Is Organization Subpart | Parent Organization LBN | Parent Organization TIN | Authorized Official Name Prefix Code | Authorized Official Name Suffix Code | Authorized Official Credential Text | Healthcare Provider Taxonomy Group Code 1 | Healthcare Provider Taxonomy Group Code 2 | Healthcare Provider Taxonomy Group Code 3 | Healthcare Provider Taxonomy Group Code 4 | Healthcare Provider Taxonomy Group Code 5 | Healthcare Provider Taxonomy Group Code 6 | Healthcare Provider Taxonomy Group Code 7 | Healthcare Provider Taxonomy Group Code 8 | Healthcare Provider Taxonomy Group Code 9 | Healthcare Provider Taxonomy Group Code 10 | Healthcare Provider Taxonomy Group Code 11 | Healthcare Provider Taxonomy Group Code 12 | Healthcare Provider Taxonomy Group Code 13 | Healthcare Provider Taxonomy Group Code 14 | Healthcare Provider Taxonomy Group Code 15 | Certification Date |
1679576722 | Individual | WIEBE | DAVID | A | M.D. | PO BOX 2168 | KEARNEY | NE | 688482168.0 | US | 3088652512.0 | 3088652506.0 | 3500 CENTRAL AVE | KEARNEY | NE | 688472944.0 | US | 3088652512.0 | 3088652506.0 | 2005-05-23 | 2007-07-08 | Male | 207X00000X | 12637 | NE | True | 46969 | OTHER | KS | BCBS | 1553 | OTHER | NE | BCBS | 645540 | OTHER | KS | FIRSTGUARD | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1588667638 | Individual | PILCHER | WILLIAM | C | DR. | MD | 1824 KING STREET | SUITE 300 | JACKSONVILLE | FL | 322044736.0 | US | 9043881820.0 | 9043881827.0 | 1824 KING STREET | SUITE 300 | JACKSONVILLE | FL | 322044736.0 | US | 9043881820.0 | 9043881827.0 | 2005-05-23 | 2014-05-29 | Male | 207RC0000X | ME68414 | FL | True | 207RC0000X | 032024 | GA | False | 0897705 | OTHER | FL | AETNA | 510265 | OTHER | GA | BCBS | 00532485C | MEDICAIDs | GA | 208143.0 | OTHER | FL | AVMED | 251286600.0 | MEDICAIDs | FL | 27888.0 | OTHER | FL | BCBS | 00706626A | MEDICAIDs | GA | False | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1497758544 | Organization | <UNAVAIL> | CUMBERLAND COUNTY HOSPITAL SYSTEM, INC | CAPE FEAR VALLEY HOME HEALTH AND HOSPICE | Doing business As | 3418 VILLAGE DR | FAYETTEVILLE | NC | 283044552.0 | US | 9106096740.0 | 3418 VILLAGE DR | FAYETTEVILLE | NC | 283044552.0 | US | 9106096740.0 | 2005-05-23 | 2011-09-26 | NAGOWSKI | MICHAEL | CEO | 9106096700.0 | 251G00000X | HC0283 | NC | True | 3401562 | MEDICAIDs | NC | False | MR. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1306849450 | 2021-03-03 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1215930367 | Individual | GRESSOT | LAURENT | DR. | M.D. | 17323 RED OAK DR | HOUSTON | TX | 770901243.0 | US | 2814405006.0 | 2814406149.0 | 17323 RED OAK DR | HOUSTON | TX | 770901243.0 | US | 2814405006.0 | 2814406149.0 | 2005-05-23 | 2014-11-25 | Male | 174400000X | H6257 | TX | False | 207RH0003X | H6257 | TX | True | False | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1023011178 | Organization | <UNAVAIL> | COLLABRIA CARE | NAPA VALLEY HOSPICE & ADULT DAY SERVICES | Former Legal Business Name | 414 S JEFFERSON ST | NAPA | CA | 945594515.0 | US | 7072589080.0 | 7072582476.0 | 414 S JEFFERSON ST | NAPA | CA | 945594515.0 | US | 7072589080.0 | 7072582476.0 | 2005-05-23 | 2020-06-09 | ANDERSON | DONALD | WAYNE | ASSISTANT SECRETARY OF ENROLLMENT | 4255255392.0 | 251G00000X | 100000741 | CA | True | HPC01537G | MEDICAIDs | CA | False | JR. | 06/09/2020 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1932102084 | Individual | ADUSUMILLI | RAVI | K | MD | 2940 N MCCORD RD | TOLEDO | OH | 436151753.0 | US | 4198423000.0 | 4198423048.0 | 2940 N MCCORD RD | TOLEDO | OH | 436151753.0 | US | 4198423000.0 | 4198423048.0 | 2005-05-23 | 2012-04-23 | Male | 207RC0000X | 35069014 | OH | True | 207RC0000X | 4301081344 | MI | False | 0178623 | MEDICAIDs | OH | P00751116 | OTHER | RAILROAD MEDICARE | False | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1841293990 | Individual | WORTSMAN | SUSAN | MA-CCC | 68 ROCKLEDGE RD | APT 1C | HARTSDALE | NY | 105303455.0 | US | 2124814464.0 | 425 E 25TH ST | NEW YORK | NY | 100102547.0 | US | 2124814464.0 | 2005-05-23 | 2007-07-08 | Female | 231H00000X | 000396-1 | NY | True | False | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1750384806 | Individual | BISBEE | ROBERT | DR. | MD | 5219 CITY BANK PKWY STE 214 | LUBBOCK | TX | 794073537.0 | US | 8067810360.0 | 8067820097.0 | 808 JOLIET AVE UNIT 120 | LUBBOCK | TX | 794151148.0 | US | 8067610540.0 | 8067610451.0 | 2005-05-23 | 2017-03-10 | Male | 207R00000X | J8461 | TX | True | False | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1669475711 | Individual | SUNG | BIN | SHENG | M. D. | 600 JEFFERSON ST STE 301 | LAFAYETTE | LA | 705016987.0 | US | 2813460018.0 | 2813460913.0 | 7629 TIKI DR | FULSHEAR | TX | 774411548.0 | US | 2813460018.0 | 2813460913.0 | 2005-05-23 | 2020-03-01 | Female | 208000000X | J1405 | TX | True | 1270548 | MEDICAIDs | TX | True | 03/01/2020 |