NPI |
1356804751 |
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 |
WRIGHT |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
KELSEY |
The first name of the provider, if the provider
is an individual. |
Provider Middle Name |
NORAH |
The middle name of the provider, if the provider
is an individual. |
Provider Name Prefix Text |
MRS. |
The name prefix or salutation of the provider
if the provider is an individual; for example, Mr., Mrs., or Corporal. |
Provider First Line Business Practice Location Address |
3118 WAKEFIELD ST |
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 |
LAWRENCEVILLE |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
GA |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
300445675 |
The second 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 Country Code If outside U S |
US |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
4042716843 |
The State code in the location of the provider
being identified. |
Provider Enumeration Date |
4/11/2019 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Last Update Date |
4/11/2019 |
The country code in the location address of the provider being identified. |
Provider Gender Code |
F |
The telephone number associated with the location address of the provider being identified. |
Healthcare Provider Taxonomy Code 1 |
106S00000X |
The fax number associated with the location
address of the provider being identified. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
The date the provider was assigned a unique identifier (assigned an NPI). |
Is Sole Proprietor |
N |
The date that a record was last updated or changed. |