NPI |
1568032373 |
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 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider Last Name Legal Name |
SHAIKH HUSSEIN |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
SARAH |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
Provider First Line Business Practice Location Address |
1275 FULTON AVENUE |
Other name by which the organization provider is or has been known. |
Provider Business Practice Location Address City Name |
COOS BAY |
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional
name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other. |
Provider Business Practice Location Address State Name |
OR |
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 Postal Code |
97420 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
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 |
5418886433 |
The telephone number associated with the location address of the provider being identified. |
Provider Enumeration Date |
6/25/2021 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Last Update Date |
8/31/2022 |
The State code in the location 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 |
1223G0001X |
The fax number associated with the location
address of the provider being identified. |
Provider License Number 1 |
11573 |
The date that a record was last updated or changed. |
Provider License Number State Code 1 |
OR |
The date that a record was last updated or changed. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Is Sole Proprietor |
N |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
NPI Certification Date |
8/30/2022 |
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