NPI |
1336310846 |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
Entity Type Code |
2 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Employer Identification Number EIN |
|
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified. |
Provider Organization Name Legal Business Name |
KENNETH W HOUCHIN, MD, DBA ELKO EYE CENTER |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Provider First Line Business Practice Location Address |
875 14TH ST |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider Business Practice Location Address City Name |
ELKO |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider Business Practice Location Address State Name |
NV |
The first name of the provider, if the provider
is an individual. |
Provider Business Practice Location Address Postal Code |
898013414 |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
7757385193 |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Fax Number |
7757786831 |
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
Provider Enumeration Date |
3/13/2008 |
The country code in the location address of the provider being identified. |
Last Update Date |
6/19/2008 |
The date that a record was last updated or changed. |
Authorized Official Last Name |
HOUCHIN |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official First Name |
KENNETH |
The first name of the authorized official. |
Authorized Official Middle Name |
WAYNE |
The middle name of the authorized official. |
Authorized Official Title or Position |
PHYSICIAN OWNER |
The title or position of the authorized official. |
Authorized Official Telephone Number |
7757385193 |
The 10-position telephone number of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
332H00000X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider License Number 1 |
8896 |
The license number issued to the provider being identified. The NPS can accommodate
multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
Provider License Number State Code 1 |
NV |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Other Provider Identifier 1 |
100502104 |
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form. |
Other Provider Identifier Type Code 1 |
05 |
The city name in the location address of the provider being identified. |
Other Provider Identifier State 1 |
NV |
|
Is Organization Subpart |
N |
|
Authorized Official Name Prefix Text |
DR. |
|
Authorized Official Credential Text |
MD |
|