NPI |
1265820252 |
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 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 Last Name Legal Name |
TAKACS |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
ANDREW |
The first name of the provider, if the provider
is an individual. |
Provider First Line Business Practice Location Address |
8757 BRECKSVILLE RD |
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 |
BRECKSVILLE |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
OH |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
441411919 |
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 |
4405460643 |
The city name in the location address of the provider being identified. |
Provider Enumeration Date |
12/30/2014 |
The State code in the location of the provider
being identified. |
Last Update Date |
12/30/2014 |
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 Gender Code |
M |
The country code in the location address of the provider being identified. |
Healthcare Provider Taxonomy Code 1 |
225200000X |
The telephone number associated with the location address of the provider being identified. |
Provider License Number 1 |
PTA 05831 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider License Number State Code 1 |
OH |
The date that a record was last updated or changed. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Sole Proprietor |
Y |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |