SCHEUBER ROAD EMERGENCY PHYSICIANS - NPI NUMBER 1851679856

Summary

Provider Name: SCHEUBER ROAD EMERGENCY PHYSICIANS

NPI Number: 1851679856

Clasification: Physician Assistant (363A00000X)

Address:
914 S SCHEUBER RD
CENTRALIA, WA
ZIP 98531

Phone Number: (360) 330-8516



Detailed Information

SCHEUBER ROAD EMERGENCY PHYSICIANS is a physician assistant in Centralia, WA. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. The assigned NPI number for this provider is 1851679856 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

914 S SCHEUBER RD
CENTRALIA, WA
ZIP 98531-027
Phone: (360) 330-8516

The provider's authorized official is Angel L Iscovich .
The authorized official title is General Partner and has the following contact phone number (805) 563-3011.

The enumeration date for this NPI number is 7/26/2011 and was last updated on 8/18/2011.

Map - Location of Practice

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 363A00000X Physician Assistant No
2 363L00000X Nurse Practitioner No
3 207P00000X Emergency Medicine Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1851679856 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 2 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 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name SCHEUBER ROAD EMERGENCY PHYSICIANS The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 914 S SCHEUBER RD 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.
6 Provider Business Practice Location Address City Name CENTRALIA The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name WA The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 985319027 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 3603308516 The telephone number associated with the location address of the provider being identified.
11 Provider Enumeration Date 7/26/2011 The date the provider was assigned a unique identifier (assigned an NPI).
12 Last Update Date 8/18/2011 The date that a record was last updated or changed.
13 Authorized Official Last Name ISCOVICH The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
14 Authorized Official First Name ANGEL The first name of the authorized official.
15 Authorized Official Middle Name L The middle name of the authorized official.
16 Authorized Official Title or Position GENERAL PARTNER The title or position of the authorized official.
17 Authorized Official Telephone Number 8055633011 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 363A00000X 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.
19 Healthcare Provider Primary Taxonomy Switch 1 N
20 Healthcare Provider Taxonomy Code 2 363L00000X
21 Healthcare Provider Primary Taxonomy Switch 2 N
22 Healthcare Provider Taxonomy Code 3 207P00000X
23 Healthcare Provider Primary Taxonomy Switch 3 Y
24 Is Organization Subpart N
25 Authorized Official Credential Text MD
26 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP
27 Healthcare Provider Taxonomy Group 2 193200000X MULTI-SPECIALTY GROUP
28 Healthcare Provider Taxonomy Group 3 193200000X MULTI-SPECIALTY GROUP

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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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