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 | 207R00000X | Internal Medicine | | | | No |
| 2 | 251E00000X | Home Health | | | | No |
| 3 | 261QC1500X | Clinic/Center | Community Health | | | No |
| 4 | 261QE0700X | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment | | | No |
| 5 | 261QE0800X | Clinic/Center | Endoscopy | | | No |
| 6 | 261QH0100X | Clinic/Center | Health Service | | | No |
| 7 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 8 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 9 | 261QM1300X | Clinic/Center | Multi-Specialty | | | No |
| 10 | 261QP2300X | Clinic/Center | Primary Care | | | No |
| 11 | 261QE0002X | Clinic/Center | Emergency Care | | | Yes |