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 | 207Q00000X | Family Medicine | | 202619 | NORTH DAKOTA | No |
| 2 | 207Q00000X | Family Medicine | | 30326 | SOUTH CAROLINA | No |
| 3 | 207Q00000X | Family Medicine | | SP032745 | PENNSYLVANIA | Yes |
| 4 | 207Q00000X | Family Medicine | | 16387-33 | WISCONSIN | No |
| 5 | 363LF0000X | Nurse Practitioner | Family | 5012335 | NORTH CAROLINA | No |
| 6 | 363LF0000X | Nurse Practitioner | Family | 0024191278 | VIRGINIA | No |
| 7 | 207Q00000X | Family Medicine | | 120881 | WEST VIRGINIA | No |
| 8 | 207Q00000X | Family Medicine | | CP003532 | SOUTH DAKOTA | No |
| 9 | 207Q00000X | Family Medicine | | 357220 | NEW YORK | No |
| 10 | 207Q00000X | Family Medicine | | GAA-NP003172 | GEORGIA | No |
| 11 | 207Q00000X | Family Medicine | | 26NJ15366600 | NEW JERSEY | No |
| 12 | 207Q00000X | Family Medicine | | 14579 | CONNECTICUT | No |