NPI |
1225794548 |
The name prefix or salutation of the provider
if the provider is an individual; for example, Mr., Mrs., or Corporal. |
Entity Type Code |
1 |
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 Last Name Legal Name |
SCHACHMAN |
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 First Name |
NICOLE |
The second 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 Credential Text |
NP |
The city name in the location address of the provider being identified. |
Provider First Line Business Practice Location Address |
460 PINE ST |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address City Name |
PROVIDENCE |
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 State Name |
RI |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Postal Code |
029071358 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The fax number associated with the location
address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
4012720220 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Enumeration Date |
11/10/2021 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Last Update Date |
1/12/2024 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Gender Code |
F |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
363LF0000X |
The code designating the provider’s gender if the provider is a person. |
Provider License Number 1 |
APRN03510 |
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 |
RI |
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’’. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Healthcare Provider Taxonomy Code 2 |
363LW0102X |
|
Provider License Number 2 |
APRN02855 |
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 2 |
RI |
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 2 |
N |
|
Is Sole Proprietor |
N |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
NPI Certification Date |
1/12/2024 |
|