MRS. VIRGINIA MARIE HUMANN, COTA - NPI NUMBER 1548591092

Summary

Provider Name: MRS. VIRGINIA MARIE HUMANN, COTA

NPI Number: 1548591092

Clasification: Skilled Nursing Facility (314000000X)

Address:
100 JEFFERY STREET
WACO, TX
ZIP 76710

Phone Number: (254) 399-6910



Detailed Information

MRS. Virginia Marie Humann, COTA is a skilled nursing facility in Waco, TX. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. The assigned NPI number for this provider is 1548591092 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

100 JEFFERY STREET
WACO, TX
ZIP 76710
Phone: (254) 399-6910

The enumeration date for this NPI number is 1/22/2010 and was last updated on 1/22/2010.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 314000000X Skilled Nursing Facility 210063 TX Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1548591092 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.
2 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).
3 Provider Last Name Legal Name HUMANN The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name VIRGINIA The first name of the provider, if the provider is an individual.
5 Provider Middle Name MARIE The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text MRS. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text COTA 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.
8 Provider First Line Business Practice Location Address 100 JEFFERY STREET 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.
9 Provider Business Practice Location Address City Name WACO The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name TX The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 76710 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 2543996910 The telephone number associated with the location address of the provider being identified.
14 Provider Enumeration Date 1/22/2010 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 1/22/2010 The date that a record was last updated or changed.
16 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 314000000X 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.
18 Provider License Number 1 210063 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’’.
19 Provider License Number State Code 1 TX 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.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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