NPI |
1104497601 |
The telephone number associated with the location address of the provider being identified. |
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 |
SANTORO |
The date that a record was last updated or changed. |
Provider First Name |
RHONDEL |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Provider Credential Text |
PLMHP |
The first name of the authorized official. |
Provider First Line Business Practice Location Address |
2661 DOUGLAS ST |
The middle name of the authorized official. |
Provider Business Practice Location Address City Name |
OMAHA |
The title or position of the authorized official. |
Provider Business Practice Location Address State Name |
NE |
The 10-position telephone number of the authorized official. |
Provider Business Practice Location Address Postal Code |
681312626 |
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 Business Practice Location Address Country Code If outside U S |
US |
|
Provider Business Practice Location Address Telephone Number |
4024559757 |
|
Provider Enumeration Date |
7/6/2021 |
|
Last Update Date |
7/6/2021 |
The date that a record was last updated or changed. |
Provider Gender Code |
M |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
101YM0800X |
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 |
12660 |
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 |
NE |
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 |
|
Is Sole Proprietor |
N |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
NPI Certification Date |
7/6/2021 |
|