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 | 146L00000X | Emergency Medical Technician, Paramedic | | | | No |
| 2 | 163WW0000X | Registered Nurse | Wound Care | | | No |
| 3 | 207Q00000X | Family Medicine | | | | No |
| 4 | 207QS0010X | Family Medicine | Sports Medicine | | | No |
| 5 | 207RS0010X | Internal Medicine | Sports Medicine | | | No |
| 6 | 2081P0301X | Physical Medicine & Rehabilitation | Brain Injury Medicine | | | No |
| 7 | 2081P2900X | Physical Medicine & Rehabilitation | Pain Medicine | | | No |
| 8 | 2081S0010X | Physical Medicine & Rehabilitation | Sports Medicine | | | No |
| 9 | 2083P0011X | Preventive Medicine | Undersea and Hyperbaric Medicine | | | No |
| 10 | 363L00000X | Nurse Practitioner | | | | No |
| 11 | 207PE0005X | Emergency Medicine | Undersea and Hyperbaric Medicine | | | Yes |