BRUCE K NEELY, MD - NPI NUMBER 1992731509

Summary

Provider Name: BRUCE K NEELY, MD

NPI Number: 1992731509

Clasification: Emergency Medicine (207P00000X)

Organization: CASCADE EMERGENCY PHYSICIANS

Address:
202 N DIVISION ST
AUBURN, WA
ZIP 98001

Phone Number: (253) 833-7711



Detailed Information

Bruce K Neely, MD is an emergency physician in Auburn, WA with 23 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. The assigned NPI number for this provider is 1992731509 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduation Year: 1992

The provider's business address is:

202 N DIVISION ST
AUBURN, WA
ZIP 98001-939
Phone: (253) 833-7711

The enumeration date for this NPI number is 6/24/2006 and was last updated on 6/10/2010.

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 207P00000X Emergency Medicine MD00032681 WA No
2 207PE0004X Emergency Medicine Emergency Medical Services MD00032681 WA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 F76150 MEDICARE UPIN WA

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1992731509 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 NEELY The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name BRUCE The first name of the provider, if the provider is an individual.
5 Provider Middle Name K The middle name of the provider, if the provider is an individual.
6 Provider Credential Text MD 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.
7 Provider First Line Business Practice Location Address 202 N DIVISION ST 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.
8 Provider Business Practice Location Address City Name AUBURN The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name WA The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 980014939 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 2538337711 The telephone number associated with the location address of the provider being identified.
13 Provider Enumeration Date 6/24/2006 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 6/10/2010 The date that a record was last updated or changed.
15 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
16 Healthcare Provider Taxonomy Code 1 207P00000X 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.
17 Provider License Number 1 MD00032681 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’’.
18 Provider License Number State Code 1 WA 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.
19 Healthcare Provider Primary Taxonomy Switch 1 N
20 Healthcare Provider Taxonomy Code 2 207PE0004X
21 Provider License Number 2 MD00032681 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’’.
22 Provider License Number State Code 2 WA 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.
23 Healthcare Provider Primary Taxonomy Switch 2 Y
24 Other Provider Identifier 1 F76150 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.
25 Other Provider Identifier Type Code 1 02 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.
26 Other Provider Identifier State 1 WA
27 Is Sole Proprietor N 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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