| NPI |
1447911227 |
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. |
| Entity Type Code |
1 |
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 Last Name Legal Name |
AQUINO |
The last name of the provider. If the provider is an individual, this is the legal name. |
| Provider First Name |
CHARLOTH |
The first name of the provider, if the provider
is an individual. |
| Provider Middle Name |
VANESA |
The middle name of the provider, if the provider
is an individual. |
| Provider Credential Text |
RN |
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 First Line Business Practice Location Address |
215 BLUFFS AVE STE 100 |
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 City Name |
ELKO |
The city name in the location address of the provider being identified. |
| Provider Business Practice Location Address State Name |
NV |
The State code in the location of the provider
being identified. |
| Provider Business Practice Location Address Postal Code |
898012466 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
| Provider Business Practice Location Address Country Code If outside U S |
US |
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 Telephone Number |
7757778477 |
The last name of the provider. If the provider is an individual, this is the legal name. |
| Provider Enumeration Date |
1/4/2022 |
The first name of the provider, if the provider
is an individual. |
| Last Update Date |
1/4/2022 |
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 Gender Code |
F |
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 Taxonomy Code 1 |
163W00000X |
The city name in the location address of the provider being identified. |
| Provider License Number 1 |
RN94269 |
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 code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
| Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
| Other Provider Identifier 1 |
1213 |
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 fax number associated with the location
address of the provider being identified. |
| Other Provider Identifier State 1 |
NV |
The date the provider was assigned a unique identifier (assigned an NPI). |
| Is Sole Proprietor |
Y |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
| NPI Certification Date |
1/4/2022 |
|