ELIZABETH DANIELLE PACK NPI 1336741016

NPI Record

The following NPI record includes the field values provided by the NPPES as well as the field definition as published in the Federal Register. The complete NPI record is also available for download in text, csv and xml formats.

Field Name Field Value Definition 1
NPI 1336741016 The State code in the location of the provider being identified.
Entity Type Code 1 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 Last Name Legal Name PACK The country code in the location address of the provider being identified.
Provider First Name ELIZABETH The telephone number associated with the location address of the provider being identified.
Provider Middle Name DANIELLE The fax number associated with the location address of the provider being identified.
Provider First Line Business Practice Location Address 5577 OLD LOGAN RD The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Practice Location Address City Name LOGAN The date that a record was last updated or changed.
Provider Business Practice Location Address State Name WV The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Provider Business Practice Location Address Postal Code 256013346 The first name of the authorized official.
Provider Business Practice Location Address Country Code If outside U S US The title or position of the authorized official.
Provider Business Practice Location Address Telephone Number 3048962371 The 10-position telephone number of the authorized official.
Provider Enumeration Date 11/9/2020 This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Last Update Date 11/9/2020 This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Provider Gender Code F This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Taxonomy Code 1 3747P1801X This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Primary Taxonomy Switch 1 Y Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Is Sole Proprietor N Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
NPI Certification Date 11/9/2020 The date on which the National Provider Identifier (NPI) was officially assigned and certified to the provider. This reflects when the provider's NPI record first became active in the NPPES system.

(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

Download NPI Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.