NPI |
1871164475 |
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 |
JONES |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
GABRIEL |
The first name of the provider, if the provider
is an individual. |
Provider Middle Name |
URIAN |
The middle name of the provider, if the provider
is an individual. |
Provider First Line Business Practice Location Address |
4641 ROSWELL RD |
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 City Name |
ATLANTA |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
GA |
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. |
Provider Business Practice Location Address Postal Code |
303423073 |
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 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 |
4044740506 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Fax Number |
4044740515 |
The fax number associated with the location
address of the provider being identified. |
Provider Enumeration Date |
7/5/2021 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Last Update Date |
7/5/2021 |
The date that a record was last updated or changed. |
Provider Gender Code |
M |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
225X00000X |
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 License Number 1 |
OT008106 |
The city name in the location address of the provider being identified. |
Provider License Number State Code 1 |
GA |
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 Primary Taxonomy Switch 1 |
Y |
|
Is Sole Proprietor |
Y |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
NPI Certification Date |
7/5/2021 |
|