NPI |
1770098931 |
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 |
MUNROE |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
MARK |
The first name of the provider, if the provider
is an individual. |
Provider First Line Business Practice Location Address |
2 WALL ST STE 400 |
The first name of the provider, if the provider
is an individual. |
Provider Business Practice Location Address City Name |
MANCHESTER |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address State Name |
NH |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
031011518 |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
6036684111 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Fax Number |
6036287757 |
The fax number associated with the location
address of the provider being identified. |
Provider Enumeration Date |
12/11/2017 |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Last Update Date |
12/11/2017 |
The license number issued to the provider being identified. The NPS can accommodate
multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
Provider Gender Code |
M |
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
Healthcare Provider Taxonomy Code 1 |
174400000X |
|
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Sole Proprietor |
N |
|