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 | 1041C0700X | Social Worker | Clinical | | | No |
| 2 | 207R00000X | Internal Medicine | | | | No |
| 3 | 207RB0002X | Internal Medicine | Obesity Medicine | | | No |
| 4 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | | No |
| 5 | 207RE0101X | Internal Medicine | Endocrinology, Diabetes & Metabolism | | | No |
| 6 | 207RH0002X | Internal Medicine | Hospice and Palliative Medicine | | | No |
| 7 | 207RI0200X | Internal Medicine | Infectious Disease | | | No |
| 8 | 207V00000X | Obstetrics & Gynecology | | | | No |
| 9 | 208000000X | Pediatrics | | | | No |
| 10 | 208100000X | Physical Medicine & Rehabilitation | | | | No |
| 11 | 2081P0004X | Physical Medicine & Rehabilitation | Spinal Cord Injury Medicine | | | No |
| 12 | 208VP0014X | Pain Medicine | Interventional Pain Medicine | | | No |
| 13 | 314000000X | Skilled Nursing Facility | | | | No |
| 14 | 363L00000X | Nurse Practitioner | | | | No |
| 15 | 207Q00000X | Family Medicine | | | | Yes |
