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NPI
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1043423510
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10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
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Entity Type
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Individual
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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).
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Is Sole Proprietor
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N
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Indicate whether provider is a sole proprietor.
- A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
- In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
- There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
- In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
- As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
- A sole proprietorship may or may not have employees.
- Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
- Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
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Provider Organization Name (Legal Business Name)
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Open Hands Medical Center
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Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
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Provider First Line Business Mailing Address
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1003 Oak Road
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The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
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Provider Business Mailing Address City Name
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Lilburn
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The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
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Provider Business Mailing Address State Name
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GA
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The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
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Provider Business Mailing Address Postal Code
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30046
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The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
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Provider Business Mailing Address Country Code
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US
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The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
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Provider Business Mailing Address Telephone Number
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470-885-8080
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The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
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Provider Business Mailing Address Fax Number
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470-885-8088
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The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
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Provider First Line Business Practice Location Address
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1003 OAK RD SW STE B
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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.
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Provider Business Practice Location Address City Name
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LILBURN
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The city name in the location address of the provider being identified.
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Provider Business Practice Location Address State Name
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GA
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The State or Province name in the location address of the provider being identified.
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Provider Business Practice Location Address Postal Code
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30047-1826
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The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
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Provider Business Practice Location Address Country Code
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US
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The country code in the location address of the provider being identified.
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Provider Business Practice Location Address Telephone Number
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470-885-8080
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The telephone number associated with the location address of the provider being identified.
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Provider Business Practice Location Address Fax Number
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470-885-8088
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The fax number associated with the location address of the provider being identified.
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Provider Enumeration Date
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05/08/2007
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The date the provider was assigned a unique identifier (assigned an NPI).
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Last Update Date
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08/08/2020
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The date that a record was last updated or changed.
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Provider Gender Code
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F
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The code designating the provider's gender if the provider is a person.
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Healthcare Provider Taxonomy Code #1
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363AM0700X
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The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
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Healthcare Provider Taxonomy 1
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Medical
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Healthcare Provider Taxonomy #1
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Provider License Number State Code 1
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GA
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Provider License Number State Code #1
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Healthcare Provider Primary Taxonomy Switch 1
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Y
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Primary Taxonomy:
- X - The primary taxonomy switch is Not Answered;
- Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
- N - The taxonomy is not the primary taxonomy.
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