Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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 | 207ZP0101X | Pathology | Anatomic Pathology | | | No |
| 2 | 2085R0202X | Radiology | Diagnostic Radiology | | | No |
| 3 | 207ZP0102X | Pathology | Anatomic Pathology & Clinical Pathology | | | No |
| 4 | 2085R0001X | Radiology | Radiation Oncology | | | No |
| 5 | 2085R0204X | Radiology | Vascular & Interventional Radiology | | | No |
| 6 | 225100000X | Physical Therapist | | | | No |
| 7 | 225X00000X | Occupational Therapist | | | | No |
| 8 | 363A00000X | Physician Assistant | | | | No |
| 9 | 363AM0700X | Physician Assistant | Medical | | | No |
| 10 | 363AS0400X | Physician Assistant | Surgical | | | No |
| 11 | 363L00000X | Nurse Practitioner | | | | No |
| 12 | 363LF0000X | Nurse Practitioner | Family | | | No |
| 13 | 363LG0600X | Nurse Practitioner | Gerontology | | | No |
| 14 | 364S00000X | Clinical Nurse Specialist | | | | No |
| 15 | 208800000X | Urology | | | | Yes |