NPI |
1972507366 |
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 |
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 Last Name Legal Name |
GORDON |
The country code in the location address of the provider being identified. |
Provider First Name |
BRET |
The telephone number associated with the location address of the provider being identified. |
Provider Middle Name |
S |
The fax number associated with the location
address of the provider being identified. |
Provider Credential Text |
D.O. |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider First Line Business Practice Location Address |
12330 METCALF AVE |
The date that a record was last updated or changed. |
Provider Second Line Business Practice Location Address |
STE 420 |
The code designating the provider’s gender if the provider is a person. |
Provider Business Practice Location Address City Name |
OVERLAND PARK |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
KS |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
662131324 |
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. |
Provider Business Practice Location Address Country Code If outside U S |
US |
|
Provider Business Practice Location Address Telephone Number |
9133239000 |
|
Provider Business Practice Location Address Fax Number |
9133239001 |
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 Enumeration Date |
6/13/2005 |
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. |
Last Update Date |
2/27/2018 |
|
Provider Gender Code |
M |
|
Healthcare Provider Taxonomy Code 1 |
207V00000X |
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 1 |
0530651 |
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. |
Provider License Number State Code 1 |
KS |
|
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Healthcare Provider Taxonomy Code 2 |
207V00000X |
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 2 |
2001015997 |
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. |
Provider License Number State Code 2 |
MO |
|
Healthcare Provider Primary Taxonomy Switch 2 |
N |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
Other Provider Identifier 1 |
209093103 |
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 |
Code indicating the type of identifier currently
or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form. |
Other Provider Identifier State 1 |
MO |
|
Is Sole Proprietor |
Y |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |