| NPI |
1215536032 |
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 |
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). |
| Provider Last Name Legal Name |
DAVIDSON |
The last name of the provider. If the provider is an individual, this is the legal name. |
| Provider First Name |
GARRET |
The first name of the provider, if the provider
is an individual. |
| Provider First Line Business Practice Location Address |
7521 BRAYTON DR |
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. |
| Provider Business Practice Location Address City Name |
ANCHORAGE |
The city name in the location address of the provider being identified. |
| Provider Business Practice Location Address State Name |
AK |
The State code in the location of the provider
being identified. |
| Provider Business Practice Location Address Postal Code |
995072667 |
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 Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
| Provider Business Practice Location Address Telephone Number |
9079295826 |
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. |
| Provider Enumeration Date |
10/22/2020 |
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). |
| Last Update Date |
10/22/2020 |
The last name of the provider. If the provider is an individual, this is the legal name. |
| Provider Gender Code |
M |
The first name of the provider, if the provider
is an individual. |
| Healthcare Provider Taxonomy Code 1 |
373H00000X |
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. |
| Healthcare Provider Primary Taxonomy Switch 1 |
Y |
The city name in the location address of the provider being identified. |
| Other Provider Identifier 1 |
N.A |
The State code in the location of the provider
being identified. |
| Other Provider Identifier Type Code 1 |
01 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
| Other Provider Identifier State 1 |
AK |
|
| Other Provider Identifier Issuer 1 |
N.A |
|
| Is Sole Proprietor |
N |
The date the provider was assigned a unique identifier (assigned an NPI). |
| NPI Certification Date |
10/22/2020 |
The date that a record was last updated or changed. |